Irish Association of Holistic Medicine

Diploma in Counselling & Psychotherapy

APPLICATION FORM 2008

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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) …………………………………………………………………….
ADDRESS. …………………………………………………………………
………………………………………………………………………………………

Telephone: ……………………….……  Mobile…………………………………

eMail…………………………………………..               


Date of Birth …………………………..…….. Occupation………………………….……..




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 1 November 2008
Balance of fees must be paid by 2 February  2009
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
Text Box: Please affix a current photo