Annual Accreditation Subscription Payment Form
Please fill in all required form fields below, you will be then taken to PayPal to make an annual auto-renew subscription of £200 (this includes Acupuncture Society membership for 1 teacher and your accreditation fee, additional teachers are charged at £100 each). You will need a PayPal account to be able to set this up.
Name
*
First Name
Last Name
Email
*
example@example.com
Date
*
-
Day
-
Month
Year
Date
Accredited Course Names
*
Number of Teachers
*
Main Teachers Name
*
First Name
Last Name
2nd Teachers Name - if Applicable
First Name
Last Name
3rd Teachers Name - if Applicable
First Name
Last Name
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Course Accreditation Annual Fee with 1 Teacher
(
£
200.00
for each
year
)
Course Accreditation Annual Fee with 2 Teachers
(
£
300.00
for each
year
)
Course Accreditation Annual Fee with 3 Teachers
(
£
400.00
for each
year
)
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