Certificate of Clinical Hypnosis Form - Campaign - Institute of Applied Psychology

First Name*

Middle Name

Surname*

Preferred Name*

Gender*

Date of Birth*

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 14.5.26

Course Amount % to pay

Certificate of Clinical Hypnosis Course 20% Deposit*

Price:

Certificate of Clinical Hypnosis Course 33.33% Deposit*

Price:

Certificate of Clinical Hypnosis Course 50% Deposit*

Price:

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Email Invoiced to

Mobile Invoiced to

Amount of Invoice

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Amount of Deposit

Credit Card

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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Domestic Student - Certificate of Clinical Hypnosis Form - Upfront