APPLICATION FORM

 If you would like to apply for a place on the above training course please complete the form below.

Surname                                First Name                                    Gender                    Date of birth
 
 

Address
 
 
 
 
 
 
 

Telephone (Work)                                                                     Telephone (Home)
 
 

Where or from whom did you learn about the College?
 
 

EDUCATIONAL BACKGROUND (State chronologically)

School/College attended         From          To           Areas of Study               Qualifications
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

EXISTING COMMITMENTS Please describe your present work situation and your family circumstances that you feel is relevant to the course requirements
 
 
 
 
 
 
 

OTHER RELEVANT STUDIES, HOBBIES AND EXPERIENCE (include here your experience of kinesiology and other healing arts)
 
 
 
 
 

REFERENCES Please give the name, occupation and telephone number of two who have known you for at least three years and who have agreed to give you a reference for this application, should we need it.

Reference 1                                                              Reference 2
 
 
 
 
 
 
 

Signed..............................................................................................
 
 

Date.....................................................

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