CONTINUOUS PROFESSIONAL DEVELOPMENT WORKSHOP APPLICATION

CONTINUOUS PROFESSIONAL DEVELOPMENT WORKSHOP APPLICATION

I wish to apply for a place on the following workshop:
Workshop:
Workshop Date:
Surname:
Forename(s):
Address:

Street Address

Street Address Line 2

CityCounty

Postal Code
Tel No (Day):

Area CodePhone Number
Tel No (Eve):

Area CodePhone Number
Mobile No:

Area CodePhone Number
Email:
Occupation:
Date of Birth:
Qualifications:
Please note the entry qualification for each workshop
Insurers:
Please note that students must be nsured to attend the workshop
Policy Number:
Expiry Date:
I have paid for the course in full.

Please make payment via bank transfer to:

Advanced Massage Techniques Services

Sort Code: 83-26-20

Account Number: 00273247

Or send a cheque payable to AMTS, with your application form to the address below:

AMTS, Deanfoot Larches, West Linton, Peeblesshire,EH46 7AX

*Please note that, after acceptance on the workshop, the fee is non-refundable.
I am happy to receive information on forthcoming courses and other relevant information

YesNo
Signature
Date:
Should be Empty: