To enroll on any of our courses please complete both steps 1 and 2 below:

1. Fill in the application form below and print this form using you browser print button. Please enclose this form with your payment.
   
   
2. E-mail the completed form using the "submit" button below.

Please make all cheques payable to "Body Basics"

Please note that to reserve a place you need to submit at least half the amount payable on application. Also to qualify for the discounted fee, you need to make the full payment by the end of the discount period.
Due to limited places this is STRICTLY NON-REFUNDABLE & NON TRANSFERABLE

Payments can by made via postal cheques, bank transfers or through payment cards (Credit / Debit / Charge cards)

FIRST name

SURNAME

Date of Birth:

Daytime
Evening Mobile

Please enroll me on the following course:

ITEC Anatomy, Physiology & Massage Diploma
VTCT Home Study Anatomy & Physiology Diploma
ITEC Aromatherapy Diploma
ITEC Reflexology Diploma
ITEC Indian Head Massage Diploma
ITEC Sports Injuries & Massage Diploma
FHT Deep Tissue Massage Diploma
FHT Lymphatic Drainage Massage Diploma
FHT Hot Stone Massage Diploma
APNT Ayurvedic & Marma Massage
Kalari Foot Massage (Chuvatti Thirumal)
FHT Thai Yoga Massage Diploma
Infant & Baby Massage - Instructors Course
FHT Baby Yoga & Soft Stretching
Reiki
Workshops (please indicate in space below)

Please provide your ITEC student number below
(if applicable)

Your general
Interests

Other interests (please specify):

Please indicate any medical conditions you suffer from or have had in the past to ascertain your suitability for the course.

Please do not leave this section blank, if not applicable please write "none".

For your safety, you can not enrol / complete the training if you are / become pregnant during the course.

Please defer the start of this course until a later, more appropriate date.

All personal & medical information will be treated in the strictest of confidence.

Please check if you would like to be added to our mailing list, to receive news and updates from BODY BASICS.

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Please note that all our courses require students to recieve as well as give massages by fellow members in the class.

Body Basics reserves the right to withdraw students who have enrolled on a course, even if they have been accepted anytime before the first formal day of the course.