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1 In this Pack you will find Introduction sheet Course summary/s (including Fees) Pre-reuisites, Study stream options Hypnosis Legislation and Association Information Biographies of Trainers /Testimonials from previous Students and Contact Information including Venue Map Upcoming Training Dates Certificate of Hypnosis Application Form (Nine Day How to Hypnotise) Diploma of Clinical Hypnosis (Power Hypnosis and Hypnotic Fascination) Component 1 Application Form Diploma of Clinical Hypnosis (12 once monthly Ongoing Training Topics) Component 2 Application Form Checklists Introduction For hypnotherapy to be effective, hypnosis itself must be effective. This is the focus of The Australian Academy of Hypnosis. Thank you for your interest in our hypnosis training at The Australian Academy of Hypnosis. We teach Practical Hypnosis to ensure therapeutic hypnotic commands work at a subconscious level. Many disciplines are used for reprogramming, improvement and change, but none have the power and completeness of correctly induced Hypnosis. We teach interested beginners and advanced therapists from all walks of life how to utilize this simple tool for effective therapy. We de-mystify the reality of Hypnotism, Mesmerism and Hypnotic Fascination for the purposes of therapy.

2 Styles and Types of Hypnosis Rick Collingwood established The Australian Academy of Hypnosis in 1996 after he recognised that many Hypnosis Training Institutions mostly teach theory or hypnosis hybrids such as NLP, or they have a significantly academic approach within their training curriculum; offering either none, or very little, practical training in actual trance inductions. During the past eighteen years, The Australian Academy of Hypnosis has now trained more than 2000 students nationally and internationally and many of them are very successful professional hypnotherapists. Rick first learned Ericksonian Hypnosis in 1992 and has practised as a full time professional hypnotist ever since. He has travelled the world studying and researching Traditional Hypnosis, Rapid Inductions and Mesmerism. What the academy brings to the training arena are real hypnosis techniues that works on a physical, mental, emotional, and spiritual level and it is these techniues that have taken Rick to the top of the profession. When he trains he doesn't hold anything back. He doesn't keep secret techniues to himself and he will teach you all that he knows and how to apply it to your own life and the lives of your clients. This is hands on training and you will learn your theory from the extensive training manuals provided. During the training you will be inducing trance under supervision from the first day and we will ensure that you get it right. After that, mastering what we teach to you will be in direct proportion to your passion for hypnosis and the practice you put into what you learn. After the completion of your initial training you will have ample opportunity for more advanced training, regular monthly and speciality training, and open access to the academy and free lifetime access to the online training and resource centre at Some of the more common styles of hypnosis or hypnotherapy are Ericksonian Hypnosis: This is a therapeutic model of hypnosis created by the American Psychiatrist Milton Erickson. Ericksonian Hypnosis is most effectively utilised by a skilled and experienced Psycho Therapist. Ericksonian hypnosis is commonly used during therapy, but does not usually reuire or effect deep trance states. After a relaxed state has been achieved by the subject, direct suggestion is replaced by ambiguity and a lot of metaphor is often used during the therapy sessions; which will usually be about 15 to 20 in number. NLP or Neuro Linguistic Programming: Regardless of what persistent slick marketing efforts may try to have you believe; NLP IS NOT HYPNOSIS. It is supposedly the study of excellence and it does have some interesting and no doubt effective strategies. NLP also offers a lot of insight into human behaviour and the mind. However, because an NLP training institute may offer NLP training under the guise of it being hypnosis that is freuently claimed by its proponents. This is amply demonstrated by the fact that after more than a decade of clinical trials and studies at respectable academic institutions; no evidence could be found to back up the many claims made about the power and effectiveness of NLP. If you are learning NLP, you are not learning hypnosis. Traditional Hypnosis: Traditional hypnosis is direct hypnosis. It is genuine hypnosis, the type of hypnosis that despite academic opinion can make many individuals do things that are against their moral patterning or usual personality. Traditional hypnosis can be blended with Mesmerism, NLP and Ericksonian Hypnosis to create a very powerful therapeutic modality that we call Hypnosis Field TherapyTM. Mesmerism: Mesmerism is derived from the presumed father of hypnosis. The German doctor Franz Anton Mesmer ( ) but it is probably more correctly described as energetic hypnosis as very few words are used to induce a mesmeric state which is affected by what is known as stroking or magnetic passes. The resulting trance is very different than hypnosis induced with verbal relaxations and commands and it is often more therapeutic when applied by a well trained and experienced practitioner Our intensive training will teach you genuine traditional hypnosis and all of its uses. You won t be bogged down with theory you will learn techniues and how to do genuine and effective hypnosis from one of the world s foremost hypnosis trainers. You will learn all of the effective means of inducing the hypnotic trance state, including rapid and instant inductions, Mesmerism and how to apply it, and also the almost forgotten art of Hypnotic Fascination and how to correctly utilise hypnosis for therapeutic purposes and self improvement. You will experience hypnosis demonstrations and partake in lots of supervised hypnosis induction practice. Our training is suitable for any adult who wants to become a clinical hypnotherapist, for hypnotherapy and other health practitioners who want to learn deep trance induction skills, and those seeking self improvement and a better understanding of the human mind and human behaviour. The curriculum is taught in an easy to learn practical format that ensures all students of The Academy become effective hypnotists. The training is comprised of both metaphorical Ericksonian styles, Mesmerism, Direct and Rapid Authoritative Inductions and Hypnotic Fascination. This uniue hypnosis training is second to none. So much so that I guarantee you will acuire a complete understanding of hypnosis coupled with the ability to confidently and correctly induce the trance state in others.

3 How To Hypnotise To Make Therapy Work (Hypnosis and Trance Induction in the context of Hypnotherapy) All courses conducted by The Australian Academy of Hypnosis are thorough and most are hands on. You will learn the practicalities of Real Hypnosis. The academic content is in-depth, focussing on the historical development, various aspects and views, plus a step-by-step how to correctly induce Hypnosis, Mesmerism and Fascinated trance states for therapeutic benefit. All training materials are supplied, examinations and assessments are open book. Approaches to therapy and sub-modalities (i.e., Hypnosis with Children and Hypnosis for Disease), Rapid Inductions, Advanced and Ye Olde techniues, Mesmerism and Fascination are explained, demonstrated and practised. There is further support beyond the training - newsletters, association introductions, peer support, forums, more experienced practitioners and specialists, old hypnosis books and directions to insurance coverage for those going professional. You Will Learn Hypnosis properly and well when you study with The Australian Academy of Hypnosis. We train traditional and therapeutic Hypnosis in a practical sense that will make the instruction / therapy work at the subconscious level permanently, safely and morally. Hypnosis Training What Are You Really Learning? Most people are not aware that there are many different styles and variations of hypnosis and trance for therapy. The Australian Academy of Hypnosis will teach you the differences between the types of Hypnotic, Mesmeric and Fascination trances. You will learn the practicalities of conducting hypnosis morally for hypnotherapy and the development of hypnosis today. Our initial nine days of training will teach you the true history of hypnosis and its uses, plus all of the effective means of inducing the hypnotic trance state, including rapid and instant inductions, and also how to correctly utilise hypnosis for therapeutic purposes. You will experience hypnosis demonstrations and partake in a significant amount of supervised hypnosis induction practice. After you have completed the nine Day Certificate training, you have ample opportunity to continue learning more advanced forms of hypnosis, by enrolling for the Diploma and attending regular monthly on-going training tutorials or enrolling and participating in other specialty trainings offered throughout the year. Our certification easily covers the hypnotic component reuired to join most professional Australian and international hypnosis associations. Academia alone a good hypnotist does not make, with 6 of the 9 days in class being practical hands on training. The Australian Academy of Hypnosis training is second to none!

4 Study Hypnotherapy with us. Certificate of Clinical Hypnosis Course Summary Nine Days ( ) on Fri, Sat, Sun Fees: ($3,500 / or $3,000 if paid in full upon registration). Please contact us directly if you reuire a payment arrangement. This is the How To Hypnotise component. A step by step on what Hypnosis is and what it is not. The component covers the historical development, therapeutic approaches and instructions. The first weekend (Fri, Sat, Sun) is focused on theory, historical development, demonstrations and understanding what hypnosis IS and what it IS NOT. The second and third weekends are hands-on practical, step by step HOW TO HYPNOTISE training to make therapeutic instructions work properly. Although DVDs and Training Manuals containing the historical development of hypnosis, hypnotic inductions, and therapeutic instructions are included and explained. You are also taught how to construct your own inductions. The practical component of the Certificate of Clinical Hypnosis reuires nine days in class training consisting of 2 x 3 day Fri Sat Sun consecutive weekends and then a final 3 days induction practice training approximately 3 months later. Nine days total in all. There is a 150 uestion open book written examination and 5 self-assessments that must be completed before the final 3 day practical workshop about 3 months later. (That means you have 3 months to complete your open book exam and self assessments OUT OF CLASS and to practice your learned skills). Upon your enrolment with full payment, you will be ed your first training manual for pre-reading and also five free hypnosis ebooks. If you secure your place with a deposit, you will be ed the pre-reading only. All training materials are supplied in hard copy when training commences. All students of The Academy have permanent free access to our on-line training academy packed with free hypnosis ebooks, training manuals, training DVDs, on-line lectures and tutorials, a student forum and mentoring and tutoring options. At the completion of the nine day Certificate of Hypnosis training with The Australian Academy of Hypnosis, you WILL have a comprehensive understanding of the development and uses of hypnosis, a WELL PRACTISED capability of inducing effective hypnotic trance in others and instructions for therapeutic benefits these are GUARANTEED. At the end of your nine days training, provided you have successfully completed and provided us with your examination and self-assessments, your Certificate of Hypnosis and Transcript of Studies will be issued. After the first 6 days of the Certificate training, any enrolled student can apply for and start training for: The Diploma of Clinical Hypnosis Starting with 12 Once Monthly On-Going Tutorials

5 Diploma of Clinical Hypnosis Four Day Power Hypnosis and Hypnotic Fascination Training (Practical Workshop) Course Summary Fees for 4 days: ($1,650) This is the PRACTICAL component reuired for the Diploma of Clinical Hypnosis. The practical workshop of Advanced Techniues is only offered to those who have learned to hypnotise. This 4 day course is a Practical HANDS-ON WORKSHOP offered twice per year for ualified Hypnotists only and is also a compulsory component for the Diploma of Clinical Hypnosis. Then training components include: Rapid Inductions Rapid induction techniues for therapeutic use The concept, demonstrations and practical doing of rapid inductions Traditional, Modern, Adaptive Mesmerism Mesmeric trance induction and therapy without words How to Mesmerise Its comparison and difference to hypnosis, Historical development and impact Hypnotic Fascination The antithesis to hypnosis Animal hypnosis, Gypsy hypnosis Exercises and processes The course includes a separate manual with instructions and procedures. A Certificate of Power Hypnosis and a Certificate of Hypnotic Fascination are issued upon completion. At the completion of both Components I & II, a Diploma of Clinical Hypnosis and a Transcript of Studies is awarded. Other Speciality Courses Mind Body Quit Smoking Weight Loss Anxiety Depression Business Success/Development Specialty one-on-one training is also available. Dealing with Disease, etc. is conducted over 3 days (Fri. Sat. Sun) One day training workshop (Sat) One day training workshop (Sun) One day training workshop (Sat) One day training workshop (Sun) 2 day training workshop (Sat, Sun)

6 COMPONENT TWO Practical and Theory Fees: $1,300 pre paid or. (Pay as you go 12 x $135 = $1,620) The fees to complete the entire Diploma of Clinical Hypnosis parts one and two are $2950. Course Summary These are the PRACTICAL and the THEORETICAL components reuired to attain the academies Diploma of Hypnosis and they must all be completed in conjunction with the four day Power Hypnosis training component. These 12 tutorials focus on the use of HYPNOSIS in therapy. The 12 topics on offer are: No. 1 January Mind-Body Communication with Hypnosis (physiology and diseasen management) No. 2 February Abreactions within Hypnosis No. 3 March Hypnosis for Pain Management No. 4 April Hypnotic Regression (present and past life) No. 5 May Script Writing and Trance Deepening No. 6 June Magnetism and Energy Shifting No. 7 July Hypnotic Transference No. 8 August Hypnosis with Children No. 9 September Conscious Subconscious Interfacing No. 10 October Successful Induction and Subconscious Compliance No. 11 November Hypnosis for Addictions and Substance Abuse No. 12 December Ethics and Running of a Clinical Practice 2 parts (a) ethical usage of hypnosis, and 9b) clinical tips and commercial recommendations) For the Diploma of Hypnosis, all 12 topics must be completed PLUS the 4 Day Power Hypnosis Workshop. Any or all of these sub-modalities are offered to any student who has completed the first six days of the Certificate of Clinical Hypnosis.

7 Hypnosis Training Payment Plans Melbourne Nine Day Certificate of Clinical Hypnosis. $3000 if paid in Full upon Registration. Or $1500 deposit and 7 x consecutive monthly payments of $300. Total payable on payment plan $3600. Nine Day Certificate of Clinical Hypnosis and full Diploma of Clinical Hypnosis including the first 4 days and the 12 once monthly ongoing training $4500 if paid in full upon registration or $2500 deposit and 9 consecutive monthly payments of $350. Total payable on payment plan $5650. Sydney and Brisbane Five Day Certificate of Hypnotism. $897 no payment plan. Diploma of Clinical Hypnosis. Complete five day Certificate of Hypnotism plus six days approx 6 months later plus on line study. $2500 if paid in full upon registration or $1500 deposit and five consecutive monthly payments of $260. Total on payment plan $2800. Perth Western Australia, please phone the office. Account payment details for Melbourne, Sydney, Brisbane are found at the bottom of individual application forms in this information pack. I... of......postcode... Phone...Mobile @... Would like to register for the following training.... I have made a full payment of $... (Complete this section if you have chosen a payment plan option) I have paid a deposit of $...I agree and understand that the balance owing is $...and will be paid in...consecutive monthly payments of $...and the total I will pay for the training is $... Furthermore I understand that my registration into this training is not cancellable and that no refunds will be given under any circumstances. Upon registering for this training I agree to complete the payments as described here and agreed to by me. Name (print full name)... Address......Postcode... Name (print full name)... Signed...Date...

8 Study Stream Options - Pre-Reuisites It is a reuirement of the Australian Academy of Hypnosis that all students be of good character and must produce a current NATIONAL POLICE CLEARANCE to commence the course and a SENIOR FIRST AID CERTIFICATE (HLTFA 301B) by the completion of the course (or within 30 days) BEFORE a certificate will be issued. All associations for hypnosis in Australia reuire the Police Clearance and Senior First Aid before admittance, so we have adopted this as our policy too. Competence in written and spoken English are reuired (not formal), as is psychological stability speak to your trainer (or psychologist) for any uestions. To begin training, you are reuested to sign a contract to never use hypnosis for any purpose other than for therapy and we teach you why it should only be used morally with respect. First you do the 9 Day Certificate of Hypnosis training and then begin the 12 Once Monthly On-Going Training components (Component II of the Diploma of Clinical Hypnosis) PLUS 4 Day Power Hypnosis and Hypnotic Fascination Training (Component 1 of the Diploma of Clinical Hypnosis) Speciality Advanced Trainings and Personal Tuition (offered only to QUALIFIED HYPNOTISTS) These are only offered once a year and are held depending on demand. Personal one-on-one training (you provide clients) by arrangement: half day / one day / two days 3 day MIND-BODY (Dealing with Disease) 2 day HYPNOSIS for BUSINESS SUCCESS and MOTIVATION 1 day QUIT SMOKING + 1 day WEIGHT LOSS 1 day ANXIETY + 1 day DEPRESSION

9 Current Hypnosis Legislation - Pre-Reuisites Hypnotherapy was deregulated in Western Australia on 5th December It is not a reuirement to be licensed to practise hypnotherapy anywhere in Australia. The various hypnosis Associations and the Hypnotherapy Council of Australia (HCA) act as self-appointed regulating bodies. Association Information The Australian Academy of Hypnosis training is approved by the Hypnothearpy Council of Australia (HCA). The HCA is the recognised governing body for Hypnosis Institutions, Schools and Associations. Most significant hypnosis Assocations recognise The Australian Academy of Hypnosis Certificate of Clinical Hypnosis as a ualification for membership. Some associations may reuire insurance coverage, police clearance, and a senior first aid certificate. Please contact them directly for details. The academy is not directly affiliated with any associations. However, we do recommend association membership, especially if you are planning to use hypnotherapy professionally. Some of the Hypnosis Associations you can apply to for membership are: PHA Professional Hypnotherapists of Australia ASCH Australian Society of Clinical Hypnotists AHA Australian Hypnotherapists Association AHA American Hypnotists Association AGH American Guild of Hypnotists Our Diploma is also recognised by the NHS in the United Kingdom. Links to the significant hypnosis associations can be found at the bottom of the training pages at: Refund Policy The refund policy for all hypnosis trainings within Australia and any other country is as follows. After acceptance into the academy training and payment of fees there will be no refunds. Students may defer any training to any euivalent future training. If the academy cancels a training in its entirety a full refund will be issued within 21 days of any such cancellation. The academy will also NOT BE RESPONSIBLE to refund any travel fares or accommodation payments to and for students who may be travelling to attend any trainings and it is recommended that if booking airfares or accommodation this is done on a changeable or refundable basis. These conditions are absolute. All students acknowledge and agree that upon being accepted for any training conducted at or by the academy they have a full understanding of, and agreement with, these terms and conditions.

10 About Our Trainers - Victoria/ NSW/Qld / US and UK Rick Collingwood Founder Rick has been practising clinical hypnosis since early 1992 and established The Queensland Hypnosis Academy in Brisbane in Then after National Training began in 2000, the more suitable title of The Australian Academy of Hypnosis was adopted. Rick first came to Perth by invitation to conduct a hypnosis workshop in October At that time he was also reuested to conduct an independent Hypnotic Regression in Casuarina Maximum Security Prison for Andrew Mallard, to assist proving his proclaimed innocence in the then up-coming appeal of his 1995 murder conviction. Since that time, The Australian Academy of Hypnosis has become firmly established as the largest hypnosis training institution in Perth. Rick has, during his extensive hypnosis career, had the pleasure of personally assisting tens of thousands of individuals, and also of training more than 2000 academy students in the proficient and correct uses and methodologies of all types of Hypnosis, Mesmerism and Fascination. Western Australia John H Vernes Principal John assisted Rick during every training course conducted by the academy since He is a professional hypnotherapist and hypnosis trainer and is the only official licensed trainer partnered with Mind Motivations and The Australian Academy of Hypnosis in Australia. His extensive clinical experience, passion and natural talent for hypnosis, assures you will learn all you need to know about hypnosis and how to use it. John has a Cert IV in workplace training and assessment, Bachelor of Arts (Philosophy, Politics), Dip. Of Remedial Therapy, practising professionally since 1998, he is a member of the Council of Clinical Hypnotherapists, the Professional Hypnotists of WA (currently vice chairperson) and Australian Natural Therapists Association. Originally starting hypnosis in 2001, John now conducts all the trainings in Western Australia under licence from the Academy. Both Rick and John take great pride seeing students from the Academy gain an understanding of the human mind and how to access the deepest realms of consciousness. Then use those skills to transform their own lives, and the lives of others, in uite remarkable ways. They both have a commitment and passion for hypnosis and how to teach it. Their common ideal is to help every student learn as much as they can, teach them so that they can then become a proud testament to the Academy by virtue of their learnt hypnosis skills. They are confident that they can teach you to comfortably induce hypnosis in other people by the end of your first 6 days of training. You will understand the development and therapeutic usage of Hypnotherapy GUARANTEED!

11 Some Testimonials from previous students - I would like to thank the Mind Motivations team for their expertise and dedicated efforts in the outstanding methods of teaching hypnosis; no other hypnosis training establishment that I know of combines 90% demonstration and practical with theory the way The Australian Academy of Hypnosis teaches. The old saying of, a picture paints a thousand words, has never been truer when learning traditional hypnosis through the AAH. Ralph N. I found the course to be concise and informative. Learning hypnosis from some of the best in the field is such a privilege. We got a lot of hands on practise and a great chance to learn from the experience of some great hypnotherapists. Thankyou. Danielle Acupunturist. A scientific and spiritual journey offering clarity and peace of mind and also the ability to now give the same to others. Kim Davis. Comprehensive, practical, amazing! The most eye-opening course I have ever done. J.H. Clinical Pain Specialist. I found this course to be invaluable. Information, techniues and the practical application of hypnosis were very well constructed, well explained and demonstrated. The self assessments were a bit daunting, but very effective as a doubling up of our new knowledge. I would advice anyone who wishes to help people therapeutically to do this course. Thank you very much. Patricia Barker Counsellor. Excellent course. Great to know you could achieve such effective results in such a short time. Jan Duckett Healer, Counsellor. I was delighted with the presentation of the hypnotherapy course that John delivered. I had always been very sceptical about hypnotherapy being a healing modality. John is very lucid and comfortable about instructing and practicing hypnotherapy. He gave us plenty of actual practice time and by the end of the second day, I was beginning to feel uite comfortable with putting someone into trance. Thanks and good on you John. D.F. I congratulate John on the way that he presents his training courses. He has a wealth of knowledge on the subject of Hypnosis and its supporting fields. John has helped me personally with long standing problems. Thank you John. Joe Drummond. When I first experienced your training style I was perturbed by the informal discussion, demonstration, and practice format that you use. I was used to a more formal structure in class. Instead of acting on my urge to object, I just thought I d immerse myself and absorb as much as I could about what you know and what you do. It worked. I finally get hypnosis and I m finally a real hypnotist! I m now much more confident. I used the Eye Lock last night on an old client and it worked just as you taught me it would. It s a breakthrough for client and therapist. I have found that people promise a lot in their trainings but when you actually get down to tin tacks you don t hear the full truth. Very few trainers will commit to other people s real success as you have done. You delivered. Thank you for being genuine. Mike Welsh. I recently completed a gov t accredited Cert IV, and while the theory side of things was great, the practical side was not, and I walked away lacking the ability to hypnotise. I felt hamstrung! Then I met Rick Collingwood, I did a course with him at The Australian Academy of Hypnosis, saw and experienced real hypnosis first hand, and walked away confident I could do it too. Within a week I had hypnotised my family. Within 2 weeks I was hypnotising friends. Weeks later, my stepdad is still responding to the direct suggestions I gave him in what was my first attempt at real hypnosis. It works! I m looking forward to further study with him, and if you really want to learn hypnosis, I suggest you learn it from Rick. Cahn Forrest.

12 Testimonials I just wanted to say the DVDs and the training manuals are excellent - I learn t more watching just one of your training DVDs than I did on my 12 month diploma course. A bit of a worry!! I m really looking forward to the 5 day Sydney course. I just wanted to ask also how many people on the actual 5 day course. I have never been hypnotised although I have done several hypno workshops as well as the one year course, so I was wondering what the chances of actually getting work with you would be. It is something I would dearly like to experience especially as I am using it with clients. Figure if you don t ask you will never know!!! Am very passionate about hypnotherapy and helping others and becoming the best practitioner possible. Regards Neil. Next Training Dates For all training dates in Melbourne Sydney and Brisbane please see the training page at rickcollingwood.com or theaustralianacademyofhypnosis.com and write your reuired training course and the location and training date on the registration form. Mind Motivations and The Australian Academy of Hypnosis Contact Information Melbourne Office / Clinic Phone rickcollingwoodhypnosis@gmail.com Street Address: Suite i84 21 Hall Street, Port Melbourne, Victoria or Rick can be contacted by rickcollingwoodhypnosis@gmail.com Our Training Facilities All Hypnosis training is currently conducted in our modern comfortable training facilities at Suite i84 21 Hall Street Port Melbourne Victoria 3207 (see map below). Training Enuiries For All Melbourne Sydney Brisbane Training enuiries please phone Rick Collingwood Mob , rickcollingwoodhypnosis@gmail.com The Academy's bank details are as follows: A/C Name Mind Motivations. Bank Commonwealth Bank BSB No A/C No Tuition times are: 9.30am pm. Breaks Morning: am, Lunch: pm, Afternoon: pm.

13 Enrolment Application Nine Day Certificate of Hypnosis Training Workshop All information remains private and confidential Course Start Date: Age: Full Name: (Please print your name clearly exactly as you would like it printed on your Certificate) Postal Address: Postcode: Phone (H): (W): (M): Current Profession? Any previous Hypnosis Experience? Yes No (If yes, please give brief details) Why do you want to attend this training? Any known Mental Illnesses? Yes No (If yes, please give brief details) Declaration: I understand that upon completion of my hypnosis training I will have acuired skills which will enable me to induce the state of hypnosis in certain other people. I also understand that The Australian Academy of Hypnosis in no way approves of or condones the use of hypnosis for any purpose other than as a therapeutic skill to assist in the physical and emotional healing of others. By enrolling and paying the fees for this training. I the undersigned fully understand that the fees ARE NOT refundable under any circumstances, unless The Australian Academy of Hypnosis absolutely cancels the training. I also understand that any training I have paid for but become unable to attend may be deferred for any eual training for up to 3 years after the cancellation. Please find enclosed my full payment (or deposit) of: $ Account details: Commonwealth Bank A/C Name: Mind Motivations. BSB: A/C No: * Please reference your payment with your name. Or by cheue made payable to: Mind Motivations can be posted to: The Australian Academy of Hypnosis PO Box 847 Port Melbourne Victoria 3207 Name: Signed: Date: / /

14 Enrolment Application 4 Day Power Hypnosis and Fascination Training 1st (Practical) Component of the Diploma of Clinical Hypnosis All information remains private and confidential Course Start Date: Age: Full Name: (Please print your name clearly exactly as you would like it printed on your Certificate) Postal Address: Postcode: Phone (H): (W): (M): Current Profession? Any previous Hypnosis Experience? Yes No (If yes, please give brief details) Why do you want to attend this training? Any known Mental Illnesses? Yes No (If yes, please give brief details) Declaration: I understand that upon completion of my hypnosis training I will have acuired skills which will enable me to induce the state of hypnosis in certain other people. I also understand that The Australian Academy of Hypnosis in no way approves of or condones the use of hypnosis for any purpose other than as a therapeutic skill to assist in the physical and emotional healing of others. By enrolling and paying the fees for this training. I the undersigned fully understand that the fees ARE NOT refundable under any circumstances, unless The Australian Academy of Hypnosis absolutely cancels the training. I also understand that any training I have paid for but become unable to attend may be deferred for any eual training for up to 3 years after the cancellation. Please find enclosed my full payment (or deposit) of: $ Account details: Commonwealth Bank A/C Name: Mind Motivations. BSB: A/C No: * Please reference your payment with your name. Or by cheue made payable to: Mind Motivations can be posted to: The Australian Academy of Hypnosis PO Box 847 Port Melbourne Victoria 3207 Name: Signed: Date: / /

15 Enrolment Application 12 On-Going Monthly Training 2nd (Theoretical) Component of the Diploma of Clinical Hypnosis All information remains private and confidential Course Start Date: Age: Full Name: (Please print your name clearly exactly as you would like it printed on your Certificate) Postal Address: Postcode: Phone (H): (W): (M): Current Profession? Any previous Hypnosis Experience? Yes No (If yes, please give brief details) Why do you want to attend this training? Any known Mental Illnesses? Yes No (If yes, please give brief details) Declaration: I understand that upon completion of my hypnosis training I will have acuired skills which will enable me to induce the state of hypnosis in certain other people. I also understand that The Australian Academy of Hypnosis in no way approves of or condones the use of hypnosis for any purpose other than as a therapeutic skill to assist in the physical and emotional healing of others. By enrolling and paying the fees for this training. I the undersigned fully understand that the fees ARE NOT refundable under any circumstances, unless The Australian Academy of Hypnosis absolutely cancels the training. I also understand that any training I have paid for but become unable to attend may be deferred for any eual training for up to 3 years after the cancellation. Please find enclosed my full payment (or deposit) of: $ Account details: Commonwealth Bank A/C Name: Mind Motivations. BSB: A/C No: * Please reference your payment with your name. Or by cheue made payable to: Mind Motivations can be posted to: The Australian Academy of Hypnosis PO Box 847 Port Melbourne Victoria 3207 Name: Signed: Date: / /

16 Enrolment Application Other Training Registration Course Name: All information remains private and confidential Course Start Date: Age: Full Name: (Please print your name clearly exactly as you would like it printed on your Certificate) Postal Address: Postcode: Phone (H): (W): (M): Current Profession? Any previous Hypnosis Experience? Yes No (If yes, please give brief details) Why do you want to attend this training? Any known Mental Illnesses? Yes No (If yes, please give brief details) Declaration: I understand that upon completion of my hypnosis training I will have acuired skills which will enable me to induce the state of hypnosis in certain other people. I also understand that The Australian Academy of Hypnosis in no way approves of or condones the use of hypnosis for any purpose other than as a therapeutic skill to assist in the physical and emotional healing of others. By enrolling and paying the fees for this training. I the undersigned fully understand that the fees ARE NOT refundable under any circumstances, unless The Australian Academy of Hypnosis absolutely cancels the training. I also understand that any training I have paid for but become unable to attend may be deferred for any eual training for up to 3 years after the cancellation. Please find enclosed my full payment (or deposit) of: $ Account details: Commonwealth Bank A/C Name: Mind Motivations. BSB: A/C No: * Please reference your payment with your name. Or by cheue made payable to: Mind Motivations can be posted to: The Australian Academy of Hypnosis PO Box 847 Port Melbourne Victoria 3207 Name: Signed: Date: / /

17 Application Checklist Application Form Completed and Signed Deposit / Full Payment Copy of recent National Police Clearance (less than 3 years) Copy of current Senior First Aid Certificate (HLMT 301B) due before Certificate of Hypnosis will be issued. 1st Day of Training Checklist Coffee Cup Map to get there