If you have difficulty with the form, don't hesitate to ask us for help
A * means that the question is compulsory, you won't be able to send the form without it.
*Your Full Name
*Your Address (please include your country)
*Date of Birth (dd/mm/yyyy)
Please upload a photo of yourself so your tutor will recognise you. Click the browse button to find your photo on your own computer, then simply select the file. It will be uploaded automatically when you send the form. Maximum file size is 1MB and acceptable file types are *.gif, *.png, *,jpg, *.jpeg. Contact us if you have difficulties!
*Your email address
Home Telephone (include country code if applicable)
Mobile Phone (include country code if applicable)
How and where did you hear about the course? You don't need to complete below unless this is where you heard about the course, and brief details are fine.
Leaflets (where?)
Magazine or newspaper ad (details?)
Website (which one?)
Other (please specify)
*Would you like to join our Goddess Temple Mailing List? You will receive updates and information about courses and occasional Goddess Temple and Goddess House news. You can, of course, choose to unsubscribe at any time and, of course, you won't be added twice if you're already subscribed.
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Sliding scale fees paid in full at the beginning of the course. A non-refundable deposit of £100 secures your place.
Scale 1: Household income below £20,000 per annum: £400
Scale 2: Household income between £20,000 and £28,999 per annum: £480
Scale 2: Household income above £29,000: £560.
We hold a policy of honesty
You may pay the balance of fees at any time up to the course start date of 31 March 2025, or by instalments:
Payment by instalments attracts a one-off £35 administration fee. Including the £35 admin fee, the payments will be (depending on your household income):
Scale 1: Income below £20,000: Deposit of £100 plus seven monthly payments of £47.86 beginning 31st March 2025. Scale 2: Income between £20,000 and £28,999 per annum: Deposit of £100 plus seven monthly payments of £59.29 beginning 31st March 2025. Scale 3: Income above £29,000 per annum: Deposit of £100 plus seven monthly payments of £70.71 beginning 31st March 2025.
Please note that to ensure your place on the course the non-refundable deposit of £100 must be paid within four weeks of course application acceptance and by 17th March 2025, or by return if the tutor’s acceptance is after this date.
Signed Terms & Conditions are an integral part of the course application process and should also be received by us within four weeks of your receiving confirmation of acceptance on the course.
Please make payments to: Glastonbury Goddess Temple.
*Please select from the list below your payment preference:
—Please choose an option—Pay in full in advancePay monthly by standing orderPay by monthly PayPal Subscription
Please fill out the following questions as fully as possible so that your tutor can get a sense of who you are. The Glastonbury Goddess Temple will hold all information given in total confidence. Each of the text areas below will expand to allow 512 characters (with a counter below to let you know where you're up to). If you need more room, please send us a separate email with further details. It will help if we can easily cross-reference an email with your form, so please include in the email your full name, address and the course you're applying for.
Current occupation
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Why do you wish to participate in this training?
What previous dance experience, if any, have you had?
What are your expectations from this training?
Is there any other relevant experience or training you would like to tell us about?
Because the nature of these trainings is transformative and energetic it is important for the teacher to know of certain mental & physical conditions. Answering these questions enables us to ensure your safe participation within the group and to recognise those times when it may be wiser to observe rather than to participate. It is a requirement for you to answer the following questions. All information is held in total confidence.
Do you suffer from any of the following conditions? (If necessary you can select multiple conditions by holding down the "Control" key and selecting as required).
EpilepsyDiabetesAsthmaHigh or low blood pressureHeart condition
*Do you have, or have you had, any medical problems of an acute or chronic nature?
*Have you ever had any mental health problems diagnosed or treated?
*Do you have any physical needs that it would be useful for your tutor to know about?
*Are you taking any drugs, prescribed or otherwise?
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If you have included any of the conditions above, please give details. The text area below will expand to allow 512 characters (with a counter below to let you know where you're up to):
We do need you to sign Terms and Conditions before you can be accepted on any course. Please download and print the Terms and Conditions now, then sign both copies and return one to us, with a note of your name and address.
If you don't have access to a printer, click here to request us to send you a paper copy of the Terms and Conditions.
Terms and Conditions can be returned to us by post, or may be scanned and returned by email but please note that we do need a legible copy that includes each page - we don't normally accept photos taken by a mobile phone.
Terms and Conditions must be signed and returned to us within four weeks of acceptance, as well as your non-refundable £100 deposit.
The form won't send without your acceptance
*I have downloaded the Terms and Conditions for this course, or requested a copy by post, and will sign and return them by post. I have read and agree to the Privacy Policy.
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