QUALIFI Level 6 Award in Advanced Aesthetic Procedures: Skin Boosters

Product

Level 6 Award in Advanced Aesthetic Procedures: Skin Boosters£1,500

First name

Last name

Email

Phone

Address

Date of Birth

Month

Day

Year

Ethnicity

Nationality

Please upload a photo ID

(Passport or Driving License etc)

EMERGENCY CONTACT INFORMATION

Please provide emergency contact name and telephone

Existing qualifications obtained with dates

Attach all certificates from the last 3 years

ADDITIONAL SUPPORT NEEDS

If English is not your first language. Do you have a English language qualification?

YES

NO

Do you have any disabilities?

Yes or No, If yes, please advise

Do you have any additional learning support needs? (e.g. hearing/ visual impairments, dyslexia,

Yes or No, If yes, please advise

Do you require any additional support while attending Ampika's Aesthetics academy?

Yes or No, If yes, please advise

CANDIDATE STATEMENT

Why are you doing this qualification?

What employment have you previously had?

What do you want to do once you have achieved this qualification?

RECOGNITION OF PRIOR LEARNING

Have you completed the following qualifications and can provide evidence?

DECLARATION OF WORK EXPERIENCE

Start date in the Aesthetics industry

Where have you worked in the last three years?

Include start & end dates, business address and the services you carried out

MENTAL HEALTH DECLARATION

Please tick if any of the below apply to you

Do you have any mental health disorders, historical or present?

Do you agree to inform us should your mental health condition worsen during the duration of the course?

Do you consent to us contacting your emergency contact should we feel that your mental health is declining during the course?

Do you suffer from depression, stress-related or emotional issues, or any other condition that causes anxiety, panic attacks, mood swings or anger?

If yes, please advise

If you suffer from anxiety, where would you put yourself on a scale or 1 to 10? With 1 being low anxiety and 10 being high levels of anxiety?

Please tick if any of the below apply to you

Have you ever had any alcohol or drug dependency or misuse, historical or present?

Are you currently seeing a GP or specialist for any condition?

Have you had any suicidal thoughts in the last 12 months?

If yes, please advise

How would you describe your stress levels, both at work and home on a scale of 1 to 10?With 1 being very low and 10 being very high

This course demands high levels of dedication, time, and energy to meet the deadlines and successfully complete it on time. This can be stressful; do you have any coping mechanisms to handle this?

YES

NO

TERMS & CONDITIONS

PAYMENTS AND DEPOSITS

Thank you for choosing to book your course with Ampika’s Aesthetics.

We are here to provide an outstanding service of excellence to you throughout your time with us here at any of our training academies.

PAYMENT PLANS

Please see below the monthly payments plans for each Qualifi course:

Qualifi Level 4 Diploma in Aesthetic Procedures for Skin Rejuvention

THIS IS LEGALLY BINDING AND FULLY ABLE TO BE ACTIONED ONCE YOU HAVE SIGNED.

Date picker

Signature

Drawing mode selected. Drawing requires a mouse or touchpad. For keyboard accessibility, select Type or Upload.