Holistic Health Training NZQA Level 5 Holistic Pulsing Foundations Registration form.
Please only complete this form if you plan to pay the $300 registration fee at the end. If you want to know more about the course before registering you can complete the expression of interest form on our website, or contact HHT on olivia@hht.co.nz.
Tutor you will be doing your training with
*
Please Select
Myffie
Corinne
Karunajoti
Please state which workshop location you plan to attend.
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Full Name
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First Name
Last Name
Date Of Birth
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-
Month
-
Day
Year
Date
Gender
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Male
Female
Non Defined
Prefer not to say
Ethnicity
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Please tell us how you heard about this course.
*
Please Select
Word of Mouth
Internet search
Social media
Referral
Other HHT courses
Website
NZQA
Other bodywork modalities
Have you done any training with HHT before?
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Yes
No
Do you have any special learning requirements?
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ESOL
Dyslexia
Audio Impairment
Visual Impairment
Physical Impairment
Other
N/A
If you already have some bodywork or client/therapist experience please outline this here (this is not a requirement, it is just to inform us where you are starting from).
Tell us a bit about your purpose for doing the course.
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Signature
*
Date
*
-
Month
-
Day
Year
Date
Continue
Continue
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