Dynamic Kinesiology Centre, 113 Eyre Street, Seaview Downs  SA  5049
Phone: 0403 815 622,  ammann@dynamickinesiology.com

Kinesiology / Nutrition Enrolment Form

 Date:....................................................................................

 First Name:……………………………….......... . Preferred Name:................................

 Surname:…………………………………………..........................…   D.O.B.:..................      

 Street:...........................................................................................................

 City:............................................................   State:............ P/Code................

 Phone: ………………….......….....................     Mobile:………………….................……  

Email:............................................................................................................    

Emergency Contact Person: 

Name: .................................. Relationship:....................... Ph: ..........................

How did you find us:.......................................................................................

 What is your profession:..... ............................................................................

 Please circle your intention:   AKA Practitioner      Cert IV        Diploma       Individual subjects only

 Course you are enrolling in delivered by Dynamic Kinesiology Centre (Seaview Downs, SA):

 KAAP:  Date........................... $.....................  DK 1: Date:....................... $.....................

TFH 1:  Date:.......................... $....................   DK 2: Date:....................... $..................... 

TFH 2: Date:........................... $.....................  DK 3:  Date:....................... $.....................

TFH 3: Date:............................ $....................  DK 4: Date: ....................... $.....................

TFH 4: Date:............................ $....................   DK Prof: Date:................... $.....................

TFH Prof: Date: .......................$.....................   Nutrition: Date:.................. $.....................

 Total payment enclosed:  $................................. Payment Method:....................................

Repeaters half price for all kinesiology / nutrition courses!
To secure your spot please email or post enrolment form plus payment ($50 non-refundable deposit)
Places are limited. 
To guarantee your participation, full course fee is required two weeks prior commencement of course.
For more information, vacancies or bookings please contact Christine Ammann, 0403 815 622 
Payment Options:
Electronic Fund Transfer – bank details available upon request:  ammann@dynamickinesiology.com
Cheque / Money orders payable to:
Dynamic Kinesiology Centre         113 Eyre Street        Seaview Downs  SA  5049
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Office Use:  Student Number:....... .................. ….

• AKA Practitioner 

• Certificate IV

• Diploma 

• KAAP:
  Kinesiology: 
  An Application for Professionals

• TFH:
  Touch for Health

• DK:
  Dynamic Kinesiology

• Nutrition

• Dates & Costs

• Enrolment form