Course Application
As places on the course are limited, early application is advised.
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Full name
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Occupation
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Address
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Telephone no
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Mobile no
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Email
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Address for correspondence (if different from above)
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Do you consider yourself to have a disability/special need? YES / NO If so, please state your disability or describe any special need/support required to assist you with your training.
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Who will be responsible for paying your fees?
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What are you hoping to achieve by the end of the course?
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Where did you hear about this course?
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Method of Payment
Terms and Conditions
1) Acceptance for a place will be based on the requirement of meeting Change's selection criteria. 2) Your place on a course is not transferable. 3) Payment should be paid in full upon the confirmation of a place and before attending the course, and it is not transferable. 4) A £30 administration fee will be deducted from the refund of the payment should you decide to withdraw from the course. 5) Should you defer payment to a later training schedule or a different course, an administration fee might occur.
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I agree with the above terms
Signature and Date:
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