academy enrolment form

Section 1 - Personal Details

Gender*

 
 

Title*

 
 
 
 
 

Other title

Forename(s)*

Surname*

Date of birth (compulsory)*

Address*

Postcode*

Your email address*

Telephone day (no gaps)*

Telephone evening (no gaps)

Emergency contact – name*

Emergency contact – Tel No (no gaps)*

Print name to appear on certificates*

Please list below any other qualifications you hold that may relate to the course you have chosen to enrol on

Title of Qualification

Level

Awarding Body


Section 2 - Employment Status

Please tick your employment status*

 
 

Section 3 – Please enrol me on the following course(s)

First Course*

1st Course start date*


Second Course*

2nd Course start date

Pre-requisite qualifications (if applicable)



Section 4 - Equal Opportunities

We are committed to a police of providing equal opportunities for all. This information is voluntary and will only be used for monitoring the equal opportunities policy.

Please select your ethnic background*


Section 5 - Learning Support

If you have a disability, illness or difficulties in reading and writing English, which of the following would help

If you have a learning need are you likely to need any additional support during the programme?

 
 

Please state if you have any of the following;*

If yes, how do you describe your learning difficulty (you will be required to produce evidence)

If you have mobility problems, are you likely to require assistance?

 
 

Other support required?


How did you discover the Soho Gyms Academy?*


Declaration

I hereby declare that I have read and understood the terms and conditions set out and those stated elsewhere including Gym Membership terms and conditions in www.sohogyms.com . I enclose my £500 deposit (applicable to Level 3 Personal Trainer course only) with this application form and will pay the balance as per the terms agreed above. I have no undisclosed relevant medical conditions which may be adversely affected by participating in this course.

I Agree*


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