AIAS Natural Medicine College Australia -Student Enrolment

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2006 Prospectus

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Student Inquiry | please read this first

If you are interested in enrolling in a specific course, but you would like to discuss study options, pricing and payment plans with a staff member, please fill out the following form and a staff member will contact you shortly. please call 1 300 880 933 (International +61 7 3394 2344) for further information.

Inquiry

I am inquiring from

Australia Other Country

Section A - Contact Details

Family Name *	Given Name *	Title
Street Address
Suburb/Province	Country	Post/Zip code
Telephone (home) *	Telephone (mobile/cell/handy)
Email Address *
Occupation	Date of Birth (dd/mm/yy)	Gender
Where did you hear about AIAS?

Section B - Background (Languages, Education, Special Needs)

Languages Spoken (in order of use)

English Language Proficiency (IELTS) Score (If applicable)

Educational Level attained

Last Year of Study

Special Needs (please type in any special requirements or concerns)

Section C - Course Details

Course Name \| list courses		Intended Start Date
Method of Study
Recognition of Prior Learning (previous courses undertaken)

Course Name	Year Completed	Institution
Course Name	Year Completed	Institution
Course Name	Year Completed	Institution

Section D - Agreement - Please read carefully then tick the appropriate box

I declare that the information I have supplied on this form is, to the best of my undertanding and belief, complete and correct. I understand that the giving of false or incomplete information is illegal, and that I may be proscecuted under Australia's laws and statutes.
Applicants Name Date
By checking this box, you agree to be bound by the above declaration. This inquiry form in no way implies any liability on the part of AIAS and further that completing this inquiry form does not guarantee any place in any course offered by AIAS.

The AIAS college of natural medicine will provide full assistance to you and keep you apprised of any changes to course structure or legislation.

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