<p> Distance Certificate in Perfumery Art Registration Form 2014/15</p><p>Your Details Surname Forename(s) Title Gender Male Female</p><p>Home Address</p><p>Postcode Tel No Email Mobile No Skype ID Date of Birth Nationality </p><p>Company Details (optional if fees paid by self – mandatory if registered via your company) Company Name </p><p>Company Address </p><p>Postcode Position Held Work Tel No Email Perfume Foundation Yes No Member Fees Who is paying your fees Self Sponsor Name of Sponsor </p><p>Address of Sponsor </p><p>Postcode Tel No Email </p><p>Please note that the Student kit is only included for enrolment to the Full certificate course or Modules 1 & 2. The Free student Website is not included when enrolling per module only. Please note that the enrolment process might take up to 10 days. Visit our Terms and Conditions for details.</p><p>£1390/$2100/€1650 Full certificate course – Fee Option 5 modules (includes kit + certification) £1440/$2160/€1730 Full certificate course – Instalment plan 5 modules (includes kit + certification) £2130/$3400/€2550 Full certificate course – 5 modules (includes kit + certification) + 10 days practical certified course at summer school £2145/$3430/€2570 Full certificate course – Instalment plan 5 modules (includes kit + certification) + 10 days practical certified course at summer school £850/$1350/€1050 Modules 1 & 2 only – Smell & Create (includes kit only – £20 shipping costs at your expense) SPECIAL FEE WHEN DISCOUNT AVAILABLE/OTHER FEE</p><p>THE PERFUMERY ART SCHOOL RESERVES THE RIGHT TO REFUSE ENROLMENT. PLEASE ENSURE YOU HAVE COMPLETED ALL INFORMATION REQUIREMENTS.</p><p>Payment </p><p>The Perfumery Art School accepts payments in STERLING, US DOLLAR and EURO via VISA/MASTERCARD CREDIT CARD, DEBIT CARD, BACS, STERLING CHEQUE and PAYPAL. For residents in the UK and Northern Ireland ONLY, whose company is the sponsor, an invoice can be sent to the FINANCE CONTACT NAME provided. Payments by STERLING cheques needs to be addressed to our registered office and made payable to ‘’Perfumery Art School UK Ltd’’. All fees are non-refundable. If you are being sponsored a signed </p><p>Cheque Please make all cheques payable to the “Perfumery Art School UK” and along with your registration form, please forward to The Perfumery Art School UK Ltd, 29 Brigg Drive, First Lane, Hessle HU13 9HG, United Kingdom. Note that the enrolment will be completed when the cheque has been cleared. BACS Transfer Please find The Perfumery Art School UK bank details below. For all payments please reference Perfumery Art School Enrolment Bank: HSBC PLC Address: Merritt Centre, Hessle, East Yorkshire Account Number: 80124079 Sort Code: 40-25-59 Account Title: Perfumery Art School UK Ltd IBAN Number: GB46MIDL40255980124079 BIC/Swift Number: MIDLGB22</p><p>Credit/Debit card You can pay by Credit card or debit card using our secure payment system online via Paypal. To do so, please visit the eBooking page on our website: http://www.perfumeartschool- uk.com/tuition-fees-201314.html , choose your course and enter the details requested. </p><p>Alternatively, please return the form and we will send you an electronic invoice. Please note that your enrolment will only be completed upon settlement of the electronic invoice. Finance payment You may pay in 3 settlements of £432 each via our online payment system. Go to the eBooking page on our website: http://www.perfumeartschool-uk.com/tuition-fees- 201314.html and choose the option ‘Instalment plan’. This will take you to the Instalment subscription page. Complete it and your instalment plan will activate automatically. Invoice (if fees Invoice (to be settled within 30 days of invoice date) – Please note a finance paid by your contact name and email address must be provided company) Please arrange an invoice (UK and Northern Ireland only) to be sent to:</p><p>Contact Name </p><p>Address </p><p>Email Address Educational Background Please give details of the level of English language and main qualification to be considered for entry. Level of English GCSE LEVEL C ESOL LEVEL 3 IELTS LEVEL 3 A LEVEL MOTHER TONGUE Qualification Place of Study Date of Award Grade Awarding Body </p><p>Specialism or Main Subjects of Study Experience Explain briefly your motivation for wanting to enrol in the course? If you have any previous experience in the field, please give details.</p><p>Application criteria Please kindly reply to the questions below in order to support your application.</p><p>Do you have access to a computer YES NO If yes, how many hours a week? and Internet ?</p><p>Which operating system do you use ? Windows Mac Which version of Office or Mac OS do you use ? If you have a website, please indicate </p><p>URL</p><p>If you do not have access to Skype, which What is the best day and time to contact you during </p><p> is the best way to contact you? the week ? </p><p>Can you spare at least 2 hours a week for What is your objective with this course? YES NO your study? Career in a fragrance or cosmetic company Are you confident you can work alone Creation of own collection/business Hobby/personal interest and keep your motivation? If no, please YES NO specify: Skills upgrade/new method of creating Teaching/training delivery Need to know the basics for my current job Other – Please specify:</p><p>Please return the completed form by post or email to: The Perfumery Art School Admin Services 29 Brigg Drive, First Lane Hessle, East Yorkshire HU13 9HG United Kingdom Tel. +44(0)203 0869956 Tel: +44(0)7917850902 Email: [email protected] </p>