Application Form All information is private and confidential Name* First Last AgeDate of BirthPlace of BirthEthnicityGender Male Female Address Street Address Address Line 2 City Postcode Tel. WorkTel. HomeTel. MobileEmail* Which course are you applying for? (Please Tick) Licentiate Full-Time Licentiate Part-Time Foundation Part-Time OccupationQualificationsAchievements: Personal and ProfessionalYour reasons for choosing the course and why you want to study homeopathy.How did you learn of The Centre for Homeopathic Education?Declaration* I confirm that the information given in this form is true, complete and accurate. I confirm that I have read the Admissions Policy. Any statements on this form which prove to be untrue or purposely misleading will cause the application to be cancelled. From time to time we would like to send you information on future events, webinars and seminars organised by CHE. Please let us know if you would like to receive this information and, if so, please tick your preference: Email Post Phone The Centre for Homeopathic Education complies at all times with the Data Protection regulation. We will hold your personal data securely and use it in order to provide you with the education you are signing up for.