Irish Health Culture Association

ENROLMENT FORM 2009 

                                                                                                   

Please tick here if you have previously been a student with IHCA / IAHM [    ]             
NAME (Mr/Ms) ………………………………………………………………

ADDRESS. …………………………………………………………………………

……………………………………………………………………………………

 

Telephone: ……………………….……  Mobile…………………………………….

 

email…………………………………………..              

 

Date of Birth …………………………..…….. Occupation………………………….……

EDUCATIONAL QUALIFICATIONS: Please give details of any educational or professional qualifications. For academic or health qualifications please include the appropriate abbreviation.

SPECIAL INTERESTS: Please give details of any professional, leisure or voluntary special interests or skills.

 

 

 

 

 

 

 

 

 

 

 

 

Please enrol me as indicated:

Course	Fee		Deposit Enclosed
Diploma in Ki Massage Therapy – 18 October ’08       q Diploma in Holistic Dietetics and Nutrition 18 October 2008  q	€2850	q  q	€1000	q

Course	Fee		Deposit Enclosed
Diploma in Yoga – 18 October ‘08  11 weekends + 6 day seminar	€3650	q	€1000	q

 

This course was recommended to me by          __________________________________________________

INTERVIEW: On receipt of your deposit an interview time will be arranged. All enrolments subject to interview; deposit is fully refundable if place is not offered or accepted.  We reserve the right to cancel the course if all places are not filled.

 Fees are non-refundable after commencement of Course.  Students may however transfer credit as appropriate.

    Cheques/ Money Orders/ Drafts should be crossed and made payable to Irish Yoga Group and returned to:

Course Administration Office, Irish Yoga Group, 66 Eccles Street, Dublin 7

Please affix a recent head and shoulders photo

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66 Eccles St Dublin 7 Ireland