This form is designed to provide us with basic information about applicants for the training course. All information will be treated as confidential.

Name: _____________________________________________

Address: ___________________________________________

__________________________________________________

Postal code: ________________________________________

Tel. no: ____________________________________________

Date of birth: ________________________________________

Preferred starting term and/or year: _______________________

1. The Technique
a. How many lessons have you had (approximately)?

b. When did you first begin taking lessons?

c. From whom have you had lessons?




d. If you have you read any books about the Alexander Technique please list them here.



2. Finance
It is important both to students and to the stability of the training course that financial security is assured during your three years training.
a. Can you cover the cost of the training? That is three terms each year, for three years, current cost per term being £1,300.

b. Are you dependent on a grant to do this course? Is your decision to train conditional upon your receiving a grant? Grants may be obtainable but it will be up to you to organise this aspect.



3. Health
Is there anything concerning your health which you believe may be to your disadvantage during your training? Please include your history of serious illnesses, operations or accidents you may have had. It would assist us to understand your needs.









4. Educational qualifications and work experience
Please outline your qualifications and work experience and any special interests you may have.










5. Further comments
Please add any other information which you feel relevant to your coming on to this training course.





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Date and Signature

Please return this form to The Alexander Technique Studio, Ms Karen Wentworth, 6 Ravenslea Road, London SW12 8SB, with a photograph you like of yourself.