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Date of enrolment
Name (this will appear on your qualifications)
First name
Surname
Home Address
Street
State/Province
Area Code
Country
Postal address if different from above
Postal address
Personal details
Company
Occupation
Date of birth
Gender
Home phone
Work phone
Mobile
Fax
Email
Country of birth
Do you speak a language other than English at home? If yes, please specify
Are you proficient in English?
Very WellWellNot WellNot at all
Do you have any disabilities that we should be aware of? If so, please specify.
Highest school level completed
Did not go to schoolYear 9 or equivalentYear 11 or equivalentYear 12 or equivalentStill at school
What year did you 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.
Employment status?
Other:
Reason for study?
Relevant experience and background
Course details
Course name
Course location
Course Date
Application Declaration
This section must be completed
Name (signature):
Bank Details
I have just paid my deposit through online banking into the bank account shown below. Exhale Pilates London (Natwest Bank) Sort Code: 60-04-24 Account number: 10289216 Ref: (Surname)