Please print, complete and return to address below:

SPECIAL FX Creative Dog Grooming Training
Willow Farm
Reedham Lane
Coningsby
Lincs
LN4 4RX

ENROLMENT FORM

Student Name...........................................................................

Start Date.................................................................................

Course Duration.........................................................................

Cost.........................................................................................

Personal Details - to be completed by student

Address................................................................................................
............................................................................................................
............................................................................................................
Telephone Number.................................................................................
E-mail address......................................................................................

Tetanus (yes or no and date of accine 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 refundable).

Balance is due to be paid 14 days before course commences.

PLEASE MAKE CHEQUES PAYABLE TO H GILL

Next of kin and contact telephone number...............................................

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