New Zealand Enrolment

Date of Enrolment*
DD slash MM slash YYYY
Name (this will appear on your qualifications)
First Name*
Surname*
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Postal address if different from above
Postal Address
Street Address City State / Province / Region ZIP / Postal Code Country
Personal details
Company
Occupation
Date
DD slash MM slash YYYY
Gender
Home Phone
Work Phone
Mobile
Fax
Email
Country of Birth
Country
Do you speak a language other than English at home? If yes, please specify
Other Language
- No
- Yes
If Yes
Are you proficient in English?
English Proficiency
- Very Well
- Well
- Not Well
- Not at all
Do you have any disabilities that we should be aware of? If so, please specify.
Disabilities that we should be aware of:
Highest school level completed
Highest school level completed
Year finish School
How many private Pilates sessions have you done in the last 12 months and where. Please specify the method of Pilates you have been working on. If you are bridging, please state details below of your previous Pilates certification.
Pilates Sessions have done
Employment status?
Employment Status
Other Employment Status
Reason for study?
Reason for Study
- To get job
- It was required for
- For personal development
- To get a job or promotion
- My job
- To develop my existing business
- To change careers
- To increase my skills
- To start my own business
- To get into another course
Other reason for study
Relevant experience and background
Relevant experience and background
Course details
Course name
Course location
Course Date
DD slash MM slash YYYY
Application Declaration
This section must be completed
*
I would like to apply for enrolment with Authentic Pilates Education New Zealand (APENZ) - teacher training course to be held at the Authentic Pilates Studio, and agree to abide by the rules, protocol and student code of conduct set by the APENZ and I agree to maintain proper behaviour during my enrolment. I understand my enrolment can be suspended or cancelled should I breach the rules and protocols, use inappropriate behaviour, or endanger others or myself. I have read and understood the APENZ Code of Ethics.*
*
I understand that a deposit of $1950 must be paid online into 03-1502-0009245-000 once my enrolment is accepted into the course. I understand that the remaining course fees are to be paid 2 weeks prior to the commencement of each seminar. Once paid, these fees are non refundable.*
*
I further agree to give APENZ fourteen (14) days notice if I do not intend to attend the seminar I have been enrolled into and agree if I fail to give such notice then I am liable for the full course fee to be invoiced.*
Name (signature)*
Bank Details
I have just paid my deposit through online banking into the bank account shown below.*
Account Deatails for NZ:
03-1502-0009245-000
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Comments
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Name (this will appear on your qualifications)

Postal address if different from above

Personal details

Do you speak a language other than English at home? If yes, please specify

Are you proficient in English?

Do you have any disabilities that we should be aware of? If so, please specify.

Highest school level completed

How many private Pilates sessions have you done in the last 12 months and where. Please specify the method of Pilates you have been working on. If you are bridging, please state details below of your previous Pilates certification.

Employment status?

Reason for study?

Relevant experience and background

Course details

Application Declaration

Bank Details

Please download your enrolment agreement, sign and hand it to your Teacher Trainer.

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