DIANE
PIETTE - KINESIOLOGY
TOUCH FOR
HEALTH COURSES
APPLICATION
FORM
Venue: Dronfield, nr. Sheffield
Cost: £190 per level
£170 if paid 4 weeks before course.
£320 for levels 1 and 2 if paid for together 4 weeks before course.
Workbook and certificate included.
Student worksheet book not included (£25) but not compulsory
Meals not included.
PLEASE PRINT OUT, FILL IN AND SEND TO :
Diane Piette,
70 Fanshaw Road, Dronfield/Sheffield S18
2LB
Tel 01246 410 737
http://www.dianepiette.co.uk
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Course Level:
____________________
Date __________________
Name: ___________________________________________________________
Address: ___________________________________________________________
___________________________________________________________________
Tel.
________________________
mob. _________________________
E-Mail: ___________________________________________
Payment (deposit £
50 non refundable) Cheque ____________________________
Cheques payable to “ Diane
Piette” {please do not post cash}
Signed
__________________________
Date _____________________