Diploma Course Application

Contact details

Your full name

Your contact number (mobile)

Your contact e-mail address

Personal details

Your age

Your current occupation

Why do you want to join this course?

Fitness to practice declaration

I confirm that I have never suffered with any mental health conditions or psychological issues including bi-polar, schizophrenia, clinical depression, general anxiety disorder, PTSD/unresolved past trauma, uncontrolled panic attacks, epilepsy/uncontrolled seizures.*

*If box left un-checked, please provide further details

Any additional health issues that might affect your studies?

Course date

Your chosen course start date
—SpringAutumn

Discount eligibility

Not applicableArmed forces (current/past)

Terms of application

I understand that this course is highly participative and that I will need to work on other students and be worked with by other students.

I understand that a minimum of 120 hours classroom attendance is required in order to receive certification, and if miss a day/weekend I will need to have a catch-up session to make up my hours. I further understand that catch-up sessions are at an additional cost of £90 per day missed for the first 3 days missed, then £30 per hour missed for each additional hour required.

I understand that there is a homework requirement of 330 hours that must be completed and all homework must be submitted (by email) by weekend 9 of the course. I further understand that all homework must be submitted and all examinations successfully completed in order to receive certification.

And finally…

Where did you hear about us?
—Word-of-mouthFree Taster EventOur blogGoogle SearchOther SearchFacebookTwitterInstagramRory-Z.comDrKateHypno.comHypnosis-Courses.comRory Z BookRory Z CourseKate BookKate CourseHypnotic Language CardsCore Values CardsExpo/ConferenceGHRBIHFHTNGHCNHCHypnotherapy DirectoryHypnosisTrainingUK.comEventBriteOther

Other: Please specify

Referral details (if applicable)