Form for Accreditation of Wellness Courses Name Last Name Full Address Country Date of Birth Gender Female Male Phone Number Primary Contact Email Choose: 1 Wellness Course 2 - 6 Wellness Courses 7 - 12 Wellness Courses 13 - 30 Wellness Courses Your Website Your Social Media The Courses you Offer Copy of your Qualifications A picture of you (for the Directory) Are you Insured? Yes No Have you had any sanctions passed against you by another regulation awarding body or accreditation board? Yes No Comments or Questions Send