NLP University Admissions Form

Enroll now and start planning your summer of learning and exploration.

We guarantee that if for any reason you need to change your plans, we will fully refund your money minus a $250 cancellation fee.
Now is the time to make final arrangements to attend. Take a few minutes to make your reservations.

Enrollment applications and deposits are due: March 15, 2012 for Practitioner Certification and Trainer and Consultancy Certification
and April 15, 2012 for Master Practitioner Certification and Master Trainer, Facilitator, Entrepreneur Certification.

Please contact Teresa to enroll: Email TeresaNLP@aol.com or call (831) 336-3457

Registration on campus takes place at the University of California (UCSC):
July 9, 12-2 PM and August 5, 12-2 PM
1156 High Street, Santa Cruz, CA 95064

Biographical Information

Name:

Address:

Country:

Email:		Phone:		FAX:

Course Information

Which NLP University Course(s) are you applying for?
Course Number: Dates: Deposit $: Total due $:
1. -
2. -
3. -

Residential Information

Yes, Residential package	Male	Female	Smoking?

Single	Double($15.00 less each night)		If double, who will you share a bedroom with?

Payment Information

Grand Total $		Deposit amount enclosed or authorized $

Balance due$

We accept Visa MasterCard (no American express)
Expiration date
Name of Cardholder

Note: This is not a secured web page. Orders placed with this page will be transmitted over the Internet with no encryption. If you wish to avoid this, please telephone your order directly to: Teresa Epstein at NLP Universtity at (831)336-3457. You may also pay by check, which must be in US Dollars (at your bank, you can request a check in US dollars to be made out to NLP University). To arrange a bank transfer, contact Teresa Epstein (TeresaNLP@aol.com) for account details.

Educational/Professional Information

Please list any relevant professional qualifications that you have:

Please list your educational degrees or diplomas. Include the institution and date:

Please list any NLP certification you have received. List the level, Trainers, organization and date:

The education being provided is solely for avocational / recreational purposes and not to provide training for employment. Such education is being pursued for personal entertainment, recreation, individual edification or as a hobby.

Participants at NLP University are expected to behave respectfully and ethically toward fellow participants, NLP University and University of California staff. Participants who disrupt the educational flow of NLPU with inappropriate behavior will not be assessed for certification and may be asked to leave the campus.

NLP University's right to deny entry into a program is reserved.

The University campus is a special learning environment. We feel privileged to offer these NLP programs at the UCSC campus, where NLP was founded. NLPU tries to maintain a conducive learning environment and would appreciate your cooperation in following the guidelines. Please feel free to check with NLP University if you have questions. Thank you for your consideration.

Press here when done.

Pressing the "Enroll me now" button above constitutes your authorization to execute this form and bill your credit card for the appropriate amount, as stated above.