Master Nutrition Consultant Course: Application 1 About You2 Application Form3 Course Options About YouName* Title Mr.Mrs.MissMs.Dr.Prof.Rev. 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DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Nationality Home TelephoneWork TelephoneMobile (Cell) PhoneEmail* Enter Email Confirm Email Date of Birth*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Profession Application Form1. How did you first hear about the CNM?*2. What are your highest qualifications?*3. What other qualifications do you have?*4. What work experience do you have?*5. What do you want to achieve by studying the Nutrition Online course?*6. When would you like to start your Course?*Signature #1:*I certify that the details given on this form are correct and I hereby apply for admission to the CNM. Course OptionsYou agree to provide us with the above personal information on the terms of our Privacy Policy that can be found www.naturopathy-uk.com/privacy-policy. There is an Enrolment Fee of £290 (non-refundable and not included in the Course Fees below) payable upon enrolment. The Enrolment Fee and Course Fees do not include books or study materials. Please see reverse for more information on this course. Please indicate how you wish to pay the following Course Fees:Enrolment Fee* Price: £ 290.00 Year 1. Biomedicine*Payment in Full - £2,950Payment in Monthly Instalments - 12 x £285 (£3,420)Year 2 & 3. Nutrition*Payment in Full - £7,700Payment in Monthly Instalments - 24 x £385 (£9,240)Alternative, Full 3 Year Payment (Save £2,260) Biomedicine & NutritionSave even more by combining Biomedicine and Nutrition into one-payment. £10,400 Please read our Enrolment Terms and Conditions, Student Rules and Privacy Policy that have been provided to you or that can be accessed at http://cnmstudent.com/terms-and-conditions-uk carefully. By signing below and making payment of the applicable Enrolment Fee, you confirm that you accept and agree to be enrolled on the above course upon our Enrolment Terms and Conditions (attached to this form), Student Rules and Privacy Policy.Signature #2:*I certify that the details given on this form are correct and I hereby apply for admission to the CNM.
