ENROLMENT APPLICATION

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STEP ONE
Your Name:
DOB:
Address:
Postcode:
Ph (H):
Ph (w):
Mobile:
Email:
Occupation, Massage or Therapy experience or Education level achieved:
Are you pregnant, have a medical condition or special learning needs?	YES NO If yes, please advise here....
Please tick T-Shirt size required:	S M L XL XXL or

STEP TWO

I wish to enrol in the following course/courses (Please tick box)

Certificate IV in Massage Therapy Practice (HLT40307)

LOCATION

COMMENCES

Part I

Part Time or Full Time or Fast Track or Intensive

Part II

Part Time or Full Time or Fast Track or Intensive

Diploma of Remedial Massage (HLT50307)

LOCATION

COMMENCES

Trigger Point

Sports Massage

Lymphatic Massage

Myofascial Part 1

Pregnancy Massage

Oncology Massage

Home Study Courses

A & P (I)

Bridging/Upgrade Modalities

A & P (II) Business Studies Safe Practices Professional Expertise Client Care Law & Work Practices

Remedial Therapies Diploma Modalities

LOCATION

COMMENCES

Myofascial 1 Myofascial 2 Reflexology Aromatherapy
Integration Therapy Injury Techniques

S.I.B.T. or Other Qualifications

LOCATION

COMMENCES

Hot Stone Therapy Pregnancy Massage Canine Myofunctional Therapy
Cranio Sacral Mini Massage Course Ear Candling Treat/Rehab Course
Detox First Aid Oncology
Other

Accommodation

Arrival Date

Departure Date

Please select your arrival & departure dates to the right

Workshops

LOCATION

COMMENCES

STEP THREE

Method of Payment: Cheque/money order Cash Credit card Direct Deposit
Cheques/Money Orders: Make payable to S.I.B.T. and sent to: Lake Spa, 1 Callaghan Close, Charmhaven NSW 2263
Cash: Cash is only received at Administration Office, 1 Callaghan Close, Charmhaven NSW
Credit Card Payments: Do not email or send credit card details over the internet. Administration Staff will contact you to arrange payment.
Credit Card payments will incur a 2% fee on total amount.
Direct Deposit: Contact Administration Office for details.

COMPLETE YOUR PAYMENT OPTIONS

This is my first course with the School of Integrated Body Therapy
YES NO
If yes, please include $88 initial enrolment fee.

Option 1:	Course Fee	$
Option 2:	Early Bird	$
Option 3:	Deposit (then Direct Debit)	$
Total	I am paying a total amount of	$

STEP FOUR

I acknowledge that I have read, understand and agree to abide by the Rules and General Conditions as set by the School as outlined (CLICK HERE TO READ AND PRINT CONDITIONS). I understand that once a program has commenced all fees are owed to the School of Integrated Body Therapy