Hypnotherapy Training Enrolment form

Yorkshire Hypnotherapy Training

Keldale House, Beal Lane, Beal, DN14 0SQ
This form is to help me decide if I can offer you a place on a training course with Yorkshire Hypnotherapy Training.

You will generally hear from us within 48 hours of your form arriving here. We will arrange an informal chat on the phone or by Zoom to make sure all your questions about the course are answered and to ensure you're a good fit for the class.

If you prefer not to submit personal details online, please contact us to request a paper copy. Thank you.

PLEASE NOTE: THE ONLY CLASS WITH PLACES AVAILABLE FOR SEPTEMBER 2025 IS NOW THE CASTLEFORD IN-PERSON OPTION.

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Data Protection

Please read my data protection policy on THIS LINK before submitting this form. It tells you how I collect, look after and use your personal data.
Under the GDPR, you need to agree to each separate use of your data. You can withdraw permission for any of these uses at any time by letting YHT know in writing.
I have read your privacy policy and agree to Debbie Waller using my personal data:*

to answer queries and provide you with supportto decide if we can offer you a place on one of our coursesto administer the course once you are enrolledto collect payment and maintain recordsto contact any third party involved in your enrolment (e.g. someone who is funding the course)
When you submit this form, we will also sign you up for the YHT monthly email newsletter. This is a legitimate business use of your contact details, since it's important for students and those waiting for courses to start to keep in touch with our activities. You can opt out at any time by unsubscribing using the link at the bottom of one of the newsletters.
Signed (type your name if completing the form online)
Today's date:*

DayMonthYear
About you
Your name as you would like it to appear on certificates*
What do you prefer to be called in class if different (e.g. nickname)?
Your pronouns (optional)
Email*
example@example.com
The best phone number to contact you and/or leave messages*
Address including post code*
Emergency contact (name and relationship to you)*
Emergency contact (phone)*
Is it OK to leave a message on that number?*

YesNo

About you
Please tick any and all that apply to you.*

I am over 21I have completed a YHT taster courseI have prior experience of hypnosis or hypnotherapyI am trained in other kinds of therapy
References

Please let your referee know you are giving their name, and ask them to look out for our email.
It can sometimes accidentally end up in a spam/junk folder, so ask them to check there if it's not received within a couple of days of you submitting the application form.
Give the name of someone we can contact for a personal reference*
Your referee should not be a member of your immediate family, or your partner. Ideally they should have known you for at least two years
Please give your referee's email address*
Why do you think you should be offered a place? (This is your chance to sell yourself: tell us about your skills or experience and/or why you would like to come on the course)
I like to chat to anyone who enrols before offering them a place. Please tell me the best times and days to ring you over the next week, and I will try to meet one of them.
Is there anything else you would like to include in your application or ask about?

Examples might be:
- are you aware of any course dates you will miss?
- details any support we can offer to help you undertake the course or assessments (e.g., if you need extra time for exams due to dyslexia, or have accessibility issues)
- is your training being funded or part-funded by someone other than yourself (e.g., an employer) that we need to invoice separately?
- do you have any questions or concerns about undertaking the course?
ARRANGING A CHAT

When you submit this form, you’ll be directed to my booking calendar. I like to have a quick chat with everyone before confirming their place on the course. Nothing formal, just a chance to get to know you a little and hear what’s bringing you to the training.

If you have already had a Discovery call, you don't need to make another appointment.

If not, please choose a time and date that suits.

The link to the booking page will also be in the email you get when you submit the form.
Declaration

By submitting this form you are accepting that
- places are offered on the basis of the information you supply and you affirm that this is true and complete
- places are offered subject to receipt of satisfactory personal references
- the format, date and venue choices are offered on a provisional basis since classes can only run if student numbers are viable
- we might ask you to provide confirmation from a medical practitioner that it is safe for you to take part in the course and/or practice after qualification, if you have a long-term or serious mental health condition
- we reserve the right not to offer you a place if classes fill or if we feel you are not a good fit for our course
It can be helpful to add yorks.ht@btinternet.com to your safe list or contacts so emails from me about your application are less likely to be treated as junk or spam.
Please verify that you are human*
Should be Empty:

Your health