APPLICATION FORM

Please print and complete this form and follow the instructions below

The eight modules contained in the Professional Hypnotherapy Course may be purchased individually.  We recommend that they are completed in order to maintain continuity and understanding of what has been taught previously. 

PLEASE TICK WHICH LESSONS YOU REQUIRE

Module One

(includes Glossary of Hypnotic Terms)

Module Two

Module Three

(includes two double-sided audio hypnotherapy recordings)

Module Four

Module Five

Module Six

Module Seven

Module Eight

(book of Scripts and Resources)

*Examination paper.

PERSONAL DETAILS

Title (Mr / Mrs / Ms/ Miss) etc.

First name

Surname

Preferred Name

Address…………………………………………………………………………………...………………………..

………………………………………………………………….…Post Code…...………………………………

Tel no. (day)………………………………...Tel no (eve)………………………………………...……………

Email address………………………………..Mobile No…………...……………………...……………………

Have you had any other counselling training or any qualifications for any form of therapy?

Course fee:  £45.00 / $70.00 (US) each lesson

Other currencies please email course@hypnoticworld.com for conversion

I enclose my cheque/money order for …………………

made payable to Hypnotic World

 I confirm that the information given is true and accurate

Signed……………………………………………………..Date………………………………...…………………