Enrolment Form
Please complete this form when you are ready to commit to a course with Everest Fitness Education
Full Name
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Full postal address
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Date of Birth
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Telephone Number
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Email address
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Emergency Contact, name and address (if different to above)
Your answer
Disabilities
Please indicate if you have any disabilities. We will then be able to assess your learning needs to ensure you are supported throughout.
Learning Difficulties
Please indicate if you have any learning difficulties. We will then be able to assess your learning needs to ensure you are supported throughout.
Have you any unspent criminal convictions?
Required
Qualifications applied for
Please list all the qualification that you would like to apply to study.
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Relevant qualifications
Please list the relevant qualifications you hold to date.
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How did you hear about us?
Signature
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Data Protection
Everest Fitness Education works within the Data Protection Act 1998. The information you provide within this form will be held on a database for the purposes of managing your application. Please tick if you prefer NOT to be contacted about new courses in the future.
Please send payment to Everest Fitness Education
Account Number 90004286 Sort Code 20-48-08 Enter the amount you are going to pay.
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