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Enrolment Form

  
Student Details
Full name ______________________________________________________
______________________________________________________
Address
Postcode ____________________ Country _____________________
Phone (day) ______________________________________________________
Phone (night) ______________________________________________________
Mobile ______________________________________________________
E-mail ______________________________________________________
Do you have any previous experience (continue on separate page if necessary)?
__________________________________________________________________
__________________________________________________________________
 
Course and Workshop Details
Course title ______________________________________________________, or
Workshop title ______________________________________________________
Workshop date _______________________ Enrolment fee _______________
 
Payment Details
I am paying by VISA ____ M/Card ____ Switch ____ Cheque ____
 
(Please make cheques payable to "Visual Approach Limited")
Card number l___l___l___l___l___l___l___l___l___l___l___l___l___l___l___l___l
Switch l___l___l___l___l Issue no.: ____  
Other details: Start date: ____ /____ Exp. date: ____ /____  
Cardholder name: ______________________________________________________
Signature:
______________________________________________________
 
Please return to: Visual Approach Limited, Mid Drumbuie, Inverness IV63 6UX
   

Thank you for enrolling with us.
You will be sent a confirmation and your student number, plus any relevant joining instructions as soon as we receive this form.
Visual Approach Limited, Mid Drumbuie, Inverness IV19 1UX
phone +44 (0)1456 459051 ~ email enquiries@visual-approach.co.uk