Leisa Brown Natural Health
91 Hornby Road, Brighton, East Sussex BN2 4JH
01273 694920  07710 439296
email info@leisabrown.co.uk
www.leisabrown.co.uk

            The Academy of Systematic Kinesiology
Balanced Health Foundation Course Reservation form

Name.…………………………………………………………………………………..

Address.………………………………………………………………………………...

………………………………………………………………………………………….

…………………………………………………………………………………………

Tel (please include landline if possible)......................................……………………..

Email.…………………………………………………………………………………..

Please reserve me a place on the Balanced Health Foundation Course Levels I-IV,
commencing on ......................................................... in Brighton, East Sussex.

I enclose a cheque for £200 (payable to Leisa Brown) as a deposit to secure my booking for the course. I confirm I will pay the remaining £400 as four instalments of £100 payable on or before each weekend of tuition.
                                                          
OR

I would prefer to pay in 6 monthly instalments of £100 - I enclose a cheque for £100 as my first instalment and to reserve my place on the course. I will pay £100 each month for the next five months, totalling £600.

I understand that on receipt of my deposit cheque I will be sent my free Balanced Health
Volume I textbook and confirmation of my booking.

Signature………………………………………………………………………………

Date……………………………………………………………………………………

The payment of a deposit is a commitment to attend.
Deposits are not refunded unless in exceptional circumstances we are forced to cancel.

Please send this form and your deposit cheque (payable to Leisa Brown) to
Leisa Brown, 91 Hornby Road, Brighton, East Sussex BN2 4JH.

Thank you for choosing The Academy of Systematic Kinesiology!