Irish Association of Holistic Medicine
Diploma in Counselling & Psychotherapy
APPLICATION FORM 2009
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![Text Box:
Please print and post this form or fax to 01-8600549
Please tick here if you have previously been a student with IHCA / IAHM [ ]
NAME (Mr/Ms)
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ADDRESS.
Telephone:
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Mobile
eMail
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Date of Birth
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.. Occupation
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This course was recommended to me by __________________________________________________
INTERVIEW: On receipt of your application an interview time will be arranged. If accepted, the deposit is payable at interview. All enrolments subject to interview; deposit is fully refundable if place is not offered or accepted. We reserve the right to cancel the course if all places are not filled.
1000 is due as deposit with enrolment form
A further 1000 is due 2 November 2009
Balance of fees must be paid by 2 February 2010
Fees are non-refundable after commencement of Course. Students may however transfer credit as appropriate.
Cheques/ Money Orders/ Drafts should be crossed and made payable to Irish Yoga Group and returned to
Administration Office, Irish Association of Holistic Medicine, 66 Eccles Street, Dublin 7](image843.gif)
