CiEP, trainingen en coaching - Registration form

Enrolment form

Enrolment form for open training & coaching programs

Do you wish to participate in one of our programs? You can enroll straightaway via this enrolment form. After we receive the completed form from you, we will contact you to agree the details.

Details of the participant:

Name of the program*:

Starting date*:

Last name*:

Surname prefix:

First name:

Initialen*:

Initials*:

Date of birth:

Function:

Telephone*:

Mobile No.:

Fax:

Postal address*:

Postcode*:

City*:

E-mail*:

If you wish to enroll several participants at the same time, please provide the names of the other participants in the 'Comments' field.

Details of the client:

Company*:

Department*:

Branch:

Last name*:

Surname prefix:

First name:

Initials*:

Function:

Address*:

P.O. Box:

Postcode*:

City*:

Telephone*:

Fax:

E-mail*:

Reference number:

Cancellation terms & conditions

When unable to come following enrolment:
- Participants can send a replacement

Cancellation costs:
- From the 20th to the 11 working day prior to the start: 50% of the cost of the training - Less than 10 working days before the start: 100% of the cost of the training

Changes to personal appointments at the workplace:
- From the 20th to the 11 working day prior to the start: 50% of the cost of the training - Less than 10 working days before the start: 100% of the cost of the training

Yes, I agree to the cancellation terms and conditions of Impulsus *

Send the invoice to:

Company:

Department:

Last name:

Surname prefix:

Initials:

Postadres:

Postal address:

City:

Comments:

The fields marked (*) are compulsory. This is solely intended to ensure correct correspondence and administration. Your personal details will be handled confidentially and will be provided to other parties.

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