Student Enrolment Form

Student Enrolment Form
First Name*
Middle Name
Last Name*
Date and place of birth*
Mother tongue*
Gender*

MaleFemale
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Telephone
Mobile phone*
Email adress*
Emergency contact *

Name

Address

CityState / Province

Postal / Zip CodeCountry
Comments
Telephone
Mobile phone *
What language do they speak?*
How would you describe your level of English?*
Regarding your physical and mental health, is there anything you think it is important for us to know in considering your application? (this will be kept confidential)*
What is your accommodation plan while at the Peredur Eurythmy training?*
Do you play a musical instrument, and if so which?*
Who bears the financial responsibility for your course?*
Fields with an asterisk are required.

All students must be over the age of 18 at the commencement of the course. There is no upper age limit. All students must be physically and mentally fit, and although we do not discriminate against applicants with disabilities the nature of the work may not be suitable for all candidates.

Please send an email with a photocopy of your passport and a CV, showing previous education, training and employment history, and proof of any qualifications.

All students must be educated to at least GCSE level or equivalent and have a good working knowledge of the english language. Visa students must be able to prove their level of English to at least B2.

To the best of my knowledge I have completed all the questions accurately and truthfully.
Signature

Clear
Date*

DayMonthYear
Peredur Eurythmy

Co-operative Bank, sort code: 08 92 99 Account number: 65120080
Should be Empty:

Student Enrolment Form

Peredur Eurythmy