Other Courses Registration Form

E-mail Address: * Name * Address * Date of Birth * Contact Number * Which Other Course are you applying for? Facial Rejuvenation Diploma Hopi Ear Candling Deep Tissue Neck & Shoulder Massage Massage For Beginners Hot Stone Massage Certificate Reflexology Refresher Introduction to Aromatherapy A non-refundable deposit of €100 is required with your application. Regretfully we cannot confirm your place on the course until this deposit has been paid. Full payment for the remaining balance is required at the commencement of the course. Please check the yes box to confirm you have read and understood these conditions. * Yes No We thank you for your application and a receipt will be forwarded to you in due course. If you have any further queries relating to the course please complete the box to the right. Date * Verification Code: Enter Verification Code: * * Required