60 Netherby Park Weybridge Surrey KT13 0AQ United Kingdom
Email jacquitew@clara.co.uk
T E A C H Y O U R S E L F C O U R S E
A P P L I C A T I O N F O R M
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The fee for the Teach Yourself Course is £77 sterling payable in full in advance. On receipt of payment you will be sent the Teach Yourself Course.
Name ___________________________________________ Address ________________________________________ __________________________________ Post Code ______________ Phone____________________ Date of Birth ____________ Profession ________________ Email address_______________________________ Reason for becoming a student : ________________________________________________________________________ ____________________________________________________________________ How did you hear about the Teach Yourself course? ________________________________________________________________________ ____________________________________________________________________ I wish to be enrolled as a student for the Teach Yourself Course. I enclose a cheque (money order in British pounds sterling for applicants outside the UK) for seventy seven pounds sterling made payable to Jacqui Tew. I AGREE NOT TO REPRODUCE ANY PART OF THE TEACH YOURSELF COURSE. This course has been written and produced by Jacqui Tew and may not be reproduced by anyone in any way without prior written permission. Signed ________________________________ Date ________________ FORM JT/INT/TYO |