Application Form

Name*

First Last

Gender*

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone*

Email:*

Skype ID:*

Your residency status*

What describes your situation best?*

Your registration with AHPRA*

What university you graduated from?*

Please give hints about your work experience, any courses you took before and past exam attempts if any*

What are your goals?*

Which course / package are you after?*

What is your target result? (score, no. of satisfactory cases, etc.)*

What are the 3 main difficulties in your exam preparation?*

How significant are these problems to you and what have you done to resolve them?

What will happen if you don't pass the exam?*

On a scale of 1-10, how serious are you in your study and achieving your ultimate goals?*

How would you feel if you passed the exam because you'd taken a course with us?*

What difference to your career and life will this success make?*

If our course has made you ready for the exam, how likely will you recommend us to others?*

What are the features of our courses that are important to you?*

Preferred session times (AEST):*

Have you booked your exam? If yes, on what date?*

When do you wish to start the course?*

AMC candidate number (if applicable)

How did you find us?*

Notes or comments

IMG SOS APPLICATION FORM