Application form - The Perry Method
Kindly fill the application form.
Email address *
I am booking
Name *
Your answer
Surname *
Your answer
Nickname /How would you like to be called *
Your answer
If you are an entrepreneur or you want your invoice under a company name please fill in: Company name, VAT number and company address
Your answer
Gender *
Phone number *
Your answer
Nationality *
Your answer
Address *
Your answer
Do you have bodywork /healthcare background. If yes, what kind? *
Your answer
Do you have NLP background. If yes, what level? *
Your answer
Do you have sport background. If yes, what level? How frequent? *
Your answer
What would you like to work on during the training? Do you have any health related goals / projects? *
Your answer
Do you have any injuries, restrictions that can prevent you from participating in any activities? If yes, what? *
Your answer
Are you on any medication? If yes, what? *
Your answer
What would you like to gain from this course? *
Your answer
Do you have any dietary restriction, special diet (allergies)? *
Your answer
Room preference *
Any questions, comments?
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