Application Form

Please print out and post to:

Pat Ki Equine Therapies
115 Swarcliffe Road
Harrogate
HG1 4QY

To apply please send in this completed form. You will need to pay a deposit of £330
Then pay the balance of £965 28 days prior to Module One
commencing …………………………date………………………year
In some cases the balance can be paid in instalments before each module e.g. £400, £300, £265. Please make all cheques out to 'Pat Ki'.

NB We operate a no-refund policy. Should you be unable to take up your place we will try to offer you one on a future course.

Name………………………………………………E-mail….………………………………………………
Address…………………………………………Phone/s………………………………………………………………………………………………………
Age………………. Current Occupation…………………………………………………………………….

I wish to join the next Equine Massage Course commencing in September 2008 And would use my qualification to:………………………………………………………………………………………….
…………………………………………………………………………………………
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I heard of your course via……………………………………………………………………………………………………………

I understand that neither Pat Ki nor Alex Jakob-Whitworth can be responsible for the misuse of techniques or materials either during or after the course and I undertake to be responsible for my own safety at all times. I also understand that my fee is not refundable.

Signed………………………………………………………..    Date…………………………………….

Please describe your experience with horses and /or therapies in full on a separate page