Forty Weeks

Infant Massage Training Course Application

I am applying to attend the Infant Massage Training on:

Name

Address:

Phone:

Occupation:

Place of Work:

Qualifications:

Any other relevant information e.g. disabilities/special needs?:

Please describe your experience of baby massage, if any

Please describe your experience working with mother and babies:

If being a Baby Massage Instructor will not be part of your present employment, how do you envisage using it?

What benefit do you expect to derive from this course?

What, if any, experience do you have of being massaged?

Please describe relevant interests & experience, e.g. massage complementary therapy, dance, yoga, meditation, etc:

What do you do for relaxation and fitness?

How did you hear of IAIM training? Please specify who, where or other

Reference

Referee - someone (not a relative) who knows you for more than three years.

Reference name:

Reference occupation:

Reference place of work:

Reference phone:

Reference address:

2026

Ennis
15th-18th September