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)
*Your email address
Home Telephone (include country code if applicable)
Mobile Phone (include country code if applicable)
*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 if you're already subscribed you won't be added again.
Fees can be paid in full in advance with a non-refundable deposit of £100 and the balance paid by 27 November 2020.
Your deposit of £100 must be paid within within four weeks of acceptance by the tutor. If you have applied within four weeks of the course start date your deposit must be received by 12 November 2020 at the latest, or by return if the tutor’s acceptance is after this date.
Fees may also be paid by instalments with your non-refundable deposit paid as above, and then by 6 monthly instalments, which are payable by standing order or Paypal subscription starting on 12 December 2020 until the final instalment, due 12 May 2021.
Including the £30 admin fee to cover banking and Paypal costs, each instalment will be £135.00.
*Please select from the list below your payment preference:
---Pay in full in advancePay monthly by standing orderPay by monthly PayPal Subscription
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?
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 a paper copy of the 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.
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.
Are you human? Help protect us all from automated spam by completing the simple "captcha" below.