WOMEN'S HEALTH TRAINING ASSOCIATES - Supporting Physiotherapists Working in Women's Health

 
MAIN ENROLMENT FORM FOR WHTA FULL DAY COURSES
 
 Note:  Enrolment for 3-4 hour Internal Practical Examination sessions are on a separate enrolment from. 
To enrol in an internal examination practical session pleaseclick here.




IMPORTANT NOTE PRIOR TO SUBMITTING THE ENROLMENT FORM BELOW:
Completion of the form below results in official enrollment for the WHTA course selected.
Submission of the form will result in an invoice being generated and sent to you for payment.
You should receive this invoice within 1 week of submitting your application form.
 
 
 
 
ENROLMENT FORM
Name (Surname, First Name)
WHTA Member
Yes
No
Primary Email Address
Secondary Email Address
Home / Personal Adress
Name and Address for Course Tax Invoice (if different to above)
Mobile Phone Number
Home Phone Number
Work Phone Number
Application for Enrolment (courses listed in date order)
FOR ALL ENROLMENTS: I wish to pay for my course by
Credit Card
Direct Deposit Transfer
I wish to be invoiced for
20% deposit immediately, balance 1 month prior
100% Full Payment immediately
Enrolment Conditions (ALL MUST be ticked to enrol): I understand that
A 20% deposit is required to secure my place
Full refund is available if cancelled >2months
80% course fee refund if cancelled >1month prior
50% course fee refund if cancelled > 1 week prior
No refund if cancelled <1 week prior
No Official Confirmation is generated on completion of this Form. Please be assured that the form will send through to us. You should receive an email from our administration staff within one week to confirm that we have received your application.