SPECIAL FX Creative Dog Grooming Training

‘Willow Farm’

Langrick Road

Coningsby

Lincolnshire

LN4 4RX

01526 345547

01526 342368

ENROLMENT FORM please print, complete and return to above address with 20% deposit to reserve course

Student Name …………………… …..…………………

Start Date ……………………….……………………….

Course Duration …………..………………..………….

Cost……………………………………………………….

Personal Details – to be completed by student

Address…………………………………………………………………………………………………

Telephone Number……………………………………………………………………………………

Email address………………………………………………………………………………………….

Next of Kin and contact telephone number………………………………………………………...

Any medical problems we should be aware of (i.e. asthma, epilepsy, eczema, back pain, allergies

etc…………………………………………………………………………………………….

Tetanus (yes or no and date of vaccine if possible)………………………………………………

Any particular breeds or subjects you wish to cover in depth…………………………………..

…………………………………………………………………………………………………………

Your aims on completion of course……………………………………………………………………

Deposit of 20% payable to reserve your course when booking. (non re-fundable)

Balance is due to be paid 14 days prior to course commencing.

PLEASE MAKE CHEQUES PAYABLE TO HAZEL GILL

Kind Regards

Hazel Gill