The Atkinson Ball College of Hypnotherapy and HypnoHealing.
PO Box 70, Southport, Merseyside, PR8 3JB


London Advanced Course - Application / Registration Form. Course Fees £1,500.00

Please complete and return to the above address.

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Full name: _________________________________________________________
Address: _________________________________________________________
  _________________________________________________________
  _________________________________________________________
Postcode: _________________________________________________________
Telephone no: _________________________________________________________
Email address: _________________________________________________________
Occupation: _________________________________________________________
Age: ___________
Relevant prior training:
Please let us know what qualifications you have received.		 _________________________________________________________

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_________________________________________________________
How long have you been in practice? _________________________________________________________
Venue: London - Regents College.

Please return this application as soon as possible, with your deposit of £150.00 to reserve your place on our Advanced Training Course (London). The fees totalling £1,500 are payable in two further instalments of £675, the first being due at least ten days prior to commencement of the course, and the second due on the third weekend.

Please make Cheques payable to C. R. Powell
Signature: _________________________________________________________
Date: ___________
Please note: Refunds of deposits cannot be offered if cancellation is received within one month of the start date of the course.