Apply online for Holistic Massage and Bodywork Diploma

For which location are you applying?*

Select Bristol Worcester

Which course are you applying for?*

Bristol (Sept 2019 - July 2020)
Worcester (Feb - Dec 2020)
Bristol (Feb - Dec 2020)

First Name*

Last Name*

Email Address*

Email Address again*

Preferred contact number*

Address 1*

Address 2

City*

County*

Postcode*

Country*

Occupation*

Educational Qualifications*

Why are you interested in this course?*

What special qualities would you bring to the training?*

What, if any, previous knowledge do you have of Anatomy and Physiology?*

Give details of any qualifications...

What, if any, previous experience do you have of giving massage? Please give dates of workshops etc.*

Please give dates of workshops etc

What previous experience do you have of receiving massage or related forms of bodywork? (eg shiatsu, Rolfing, zero balancing)*

How do you take care of yourself (eg exercise, Yoga, T’ai Chi, dance)?

Do you use counselling, psychotherapy or other therapies to support your personal growth?*

If yes, please explain

Please select if any of the following factors, past and present, may affect your capacity to participate in the massage course and complete it successfully:

Short or long term physical condition, illness or ongoing issue
Major surgery
Mental health, emotional condition or ongoing issue
Major loss or bereavement
Specific learning needs

Please provide further information for the above.*

Arising from your previous response, what learning support might you need?*

How do you see the massage training contributing to your personal development?*

Is there anything else you would like to say about yourself?

How did you hear about this course?

Word of mouth
Flyer
The Spark
Bristol 24/7
Bristol Life Magazine
Google
Other internet search
Facebook
Email from BCMB
From a massage therapist who trained at BCMB
Attended a previous course/workshop
Event
Other

Would you like to be added to the BCMB mailing list?*

Yes
No