Domestic Student - Certificate of Clinical Hypnosis Enrolment Form - Retail - Payment Plan

First Name*
Middle Name
Surname*
Preferred Name*
Gender*
Date of Birth*
DD slash MM slash YYYY
Student Status*
- I am a new IAP student
- I am an existing IAP student
- I am a past IAP graduate
Mobile*
Email*
Enter Email Confirm Email
Date of Sessions*
I understand that the course is an online course*
- I understand that the course is an online course*
I understand that some assessments will require me to record myself performing skills and submit the recordings for assessment*
- I understand that some assessments will require me to record myself performing skills and submit the recordings for assessment*
I understand that some assessments will require me to be physically in the same room as the mock client (even if recording the assessment)*
- I understand that some assessments will require me to be physically in the same room as the mock client (even if recording the assessment)*
I understand that this course contains content, concepts and scenarios that may be distressing.*
- I understand that this course contains content, concepts and scenarios that may be distressing.*
I understand that I am fully responsible for my own personal resilience and any potential emotional triggers when participating in the course.*
- I understand that I am fully responsible for my own personal resilience and any potential emotional triggers when participating in the course.*
Enrolment Acknowledgements and Declarations:
I declare that to the best of my knowledge:*
- I declare that to the best of my knowledge:*
  - I have read and understand the entry requirements of the course and I believe I satisfy them
  - I have the level of English required to complete this course
  - I have the following basic skills and competencies required for this course:
    
    Good computer skills
    
    Empathy, patience and the ability to empower others
    
    Good English language skills
    
    Good critical thinking skills
I have read, understand and agree to the Terms and Conditions of enrolment*
- I understand that:*
  - I have 14 days from the time of my enrolment being finalised to withdraw and receive a refund of fees minus a $250 administration fee IF I have not accessed any of the course unit materials
  - After the 14 days have passed, I am no longer eligible for a refund of any fees paid
  - My course access will be limited until such time as my enrolment is completed
  - Access to the course will be restricted or suspended if fees are not paid or I fall behind in any agreed payments
Payment*
Certificate of Clinical Hypnosis Course Price*
Price:
Pricing Expires 14.9.26
Course Amount % to pay
Certificate of Clinical Hypnosis Course 10% Deposit*
Price:
Pricing Expires 14.9.26
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Amount of Deposit
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Coupon
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This Sets The Type of course

The type of the activity. w = workshop, p = accredited program, el = e-learning
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Total
$ 0.00
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IMPORTANT: PLEASE ONLY CLICK SUBMIT ONCE AND ALLOW 1-2 MINUTES FOR YOUR PAYMENT TO PROCESS. THIS WILL PREVENT ANY DOUBLE CHARGING.