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Short Courses Application Form
Mr/Mrs/Miss/Ms/Other
Surname
Forename
Date of Birth
00/00/0000
Address
Postcode
Telephone No:
Email
Hypnotherapy Qualification (s)
with dates
Number of Years of Practise
Approximate Number of Clients Seen Per Week
Specialisations (if any)
Other relevant qualifications
Reason for interest in course for which applying
Any special dietary or accommodation requirements
Note – Partners are discouraged from attending together on the same course as this can have an inhibiting effect on the development of the individual. This is partly due to the nature of the course and partly because of the student may encounter resistance during the practice of hypnoanalytical techniques in week two of the course.
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