Course Application Form
 

Course(s) applied for - please tick as appropriate  
       

Foundation Progressive Kinesiology

Nutritional Studies

Diploma in Progressive Kinesiology

Diploma in Anatomy and Physiology

Practice Management
       
Name Date of birth
Address Occupation
Town Telephone
County Fax
Post Code Email
   
Courses attended/qualifications gained - If you are applying for the Kinesiology Diploma course you must
include a copy of your Foundation certificate/ TFH/ Balanced Health certificate:
Reasons for wishing to attend this course:
   
How did you hear about this course: Date

 
   

Please note that you will now be contacted to arrange an interview. You will be asked to provide two
references in support of your application and to sign forms to state you have no criminal convictions.

The Progressive Kinesiology Academy reserves the absolute right to refuse admission on to a course
or to request that a student discontinues a course where this is deemed necessary.


Miranda Welton
Progressive Kinesiology
10 Barn Fields, Stanway
Colchester, Essex CO3 0WL
 Elizabeth Hughes
Green Rose Health Centre
91a Peace Road, Stanway
Colchester, Essex CO3 0HW


NOTE:- If you would prefer to print and post the form, print by clicking 'File' (top right hand corner of
the page), select 'Print'. Alternatively right click on the page, select 'Print'.
Please post to either of these addresses.