Bach Centre Level 3 Application Form

Use this form to apply for a place on course C4/10, which runs from the 23rd to 26th November 2010.

Complete all sections and click the Submit button at the bottom. This will take you to a payment page where you can pay for the course via Paypal secure payments; or pay over the phone or by fax or letter.

Completion of this application form does not guarantee the offer of a place on a course. Students must attend level 2 before attending level 3.

*Required field.


*First name (the name you like to be known by):


*Surname:


*Address:


*Phone:


*Email address:


Date of birth:


*Tell us where and when you attended (or will attend) level 2 and give the name of your teacher or course provider:


Where and in what capacity are you employed?


Why do you want to attend a level 3 practitioner course?


Where do you see or plan to see clients for Bach work (e.g. home, clinic, health store etc.)?


What is the average number of clients you see or expect to see in a week?


Are there any groups of clients you would not be able to help with Bach?


Are there are types of clients you feel especially qualified to help with Bach?


How long have you been using the 38 remedies? - for yourself, for family and friends, for clients?


Do you possess any other special skills or qualities that would be an asset to a Bach Foundation Registered Practitioner?


Other therapies you offer:


Existing therapeutic qualifications, if any, with details of where you achieved them:


Any experience or training you have in counselling or giving advice:


Other professional qualifications:


Other training you are undertaking, and planned finishing date:


Any other comments: