CNM Application Form UK - Step 1 of 6

Title *

Forename(s) *

Surname *

House No or Name *

Street *

Town *

County *

Postcode *

Country *

Home Phone *

Work Phone

Profession *

Nationality *

Day of Birth *

Month of Birth *

Year of Birth *

Email *

Where would you like to study? *

Where did you hear about CNM? *

Please provide details on how you heard about CNM:

If you were recommended, please give the name of the referrer. If not, then write "None". *

What 'O Levels' or GCSE's do you have (please state grades)? *

What 'A Levels' do you have (please state grades)? *

What other qualifications do you have? *

What work experience do you have (state length and qualification obtained)? *

Have you attended any other courses on Medicine, Naturopathy or Complementary Medicine? If so please give details. *

If you have a CV please upload it.

Choose file...

Please upload a copy of your passport.

Choose file...

We must have this to verify you are allowed to study with us.

What would you like to achieve by studying this course? *

Registration Details

Please state how you would like to progress on your CNM study.

Start Date. *

Please indicate how you intend to finance your proposed course of study. *

I certify that the details given on this form are correct and I hereby apply for admission to the CNM.

Please provide a password if you are new to CNM.

Please re-type your password.