Student Enrolment Form

Strictly Private and Confidential Student Enrolment Form

We offer services for individuals, organizations, and businesses. Please complete the relevant section below:

Full name/s:

Address:

Postcode:

Preferred Pronoun:

Mobile No:

Your email

Date of birth:

Gender:

Disability (do you consider yourself to have a physical or mental disability or health condition?) Please advise:

Name of organisation/business:

Contact name and title:

Organisation/business address:

Postcode:

Telephone no:

Mobile no:

Email:

How many people would the service be for?

Age range:

Reason/s for Enrolment on this course - please detail any issues you may need help with:

What improvements would you like to see?

What challenges you are facing in achieving this?

Any other information:

Contact name and title of person completing this form

Please print full name:

Please sign:

Date:

Please return this form to: ramana@ramanadevi.com

By signing this form, you are giving consent for Ramana Devi to retain this information, to ensure that we deliver the right service for you. The information you have given is confidential and covered by the Data Protection Action 1998. It will be stored securely and will not be shared with anyone outside of our organisation without your permission, unless due to duty of care under safeguarding regulations. We have a commitment to safeguarding children and vulnerable adults. If at any time you wish to withdraw your consent for our organisation to retain your personal information, please email info@ramanadevi.com

Enter your email Address

Student Enrolment Form

Strictly Private and Confidential Student Enrolment Form