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M.P.R.

International School
Switzerland I Italy I Mexico I Spain I Argentina I India

Via Cimavilla, 11-25047 - Boario Terme (BS)


Office Use
Application No

Application Form
MASTER CERTIFICATE IN

Osteopathic Postural Manual Therapies


Personal Details

PLEASE FILL IN CAPITAL LETTER

First Name:

last name:

Nationality:

Mobile No.:

Birth date:
/
Email.

Address:

Age:

Sex:
M

Recent Passport
Size
Photograph of
Student

State:

Pin Code:

Father/Mother/Spouse Name:..Emergency Contact No.:

Educational Record
Sl.
No.

Qualification

Institute

University

Year of Passing

Percent of
Marks

Fee Payment Details


Demand draft

Bank transfer

Office Use

Transaction Number: .
DD NoAmount...

Payment:
Bank Name:

Bank Name ...Date

Admission Approval:
Branch: ..

Mail the proof of fee payment along with filled application form to mprasiaschool@gmail.com
Declaration by Student:
I ... s/o, d/o, w/o .Date: ..
I have read and understood the various terms and conditions regard to admission to this course. I understand that by signing this application form I agree all
the term and conditions of regards to this course.

Signature of Student: Date: .. Place: .

Please Read before application (Terms & Conditions)

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The MPR International School holds all rights reserved in the process of selection of candidate based on their
application.
MPR International School or any of associate will not be responsible for any loss or personal unpleasant
consequences during entire course in India or abroad (Its advised to student to get appropriate
travel/health/personal risk insurance)
Signing the application form means you have fully understood about the course you are applying for including
its validity/authenticity/ its applicability/affiliation etc. Signing application/applying for course is completely
the students personal decision.
Course lecture will be in English language, student must be able to read/write/speak/understand English
language.
Application/enrolment to course is not transferable to others.
The course organizers will not be responsible to local stay or travel expenses (the only stay in 6th module in
Italy is included along with other benefits in fee package)
Approval of visa is sole responsibility of student. Consequences related to denial of visa organizers will not be
responsible.
All travel expenses (Including India & Abroad)/air fare/ticket/hotel stay/all other expenses (that is not included
in fee package) will be responsibility of student.
All work related to visa including processing documentation/fee/interview schedule etc. is entirely
responsibility of the student.
Course organizers/school reserve rights to withhold certificate in case to not fulfilling the criteria to award
certificate such as absence during classes/module workshop.
Its sole responsibility of students to keep them updated about course venue, date and timing.
Absence from practical class will results in to attend the same module again to get certificate subjected to
availability of seat and approval of school authority.
In case of failure to attend last module and exam, students will have opportunity to attend the next scheduled
exam to get the certificate, subjected to availability of seat and approval of school authority.
Once fee paid is not refundable.
In case of any change of course date/time/venue/faculty will be intimated to all students in advance. The only
registered email/phone numbers will be used for communication. Although changes are unlikely and will be in
extreme unavoidable circumstances, but students are requested to keep them updated.
School reserve the rights to terminate the registration at any point of time during course as per disciplinary
policy of school.
Its advised to all students to be sure about the course contents and applicability. School of organizers does
not take any responsibility or assurance for job at any circumstances.
Students must have all necessary documentation/medical insurance/travel insurance/valid passport/visa etc.
School or organizers does not take any responsibility towards the same.
All the communication with school and student will be done through registered email/phone only.
Failure to pay fee on time may results in cancellation of enrollments. Fee deposited will not be refunded at
any cost.
Any query from student will entertained if sent to authorize school email only.
Any legal proceeding arising regard to the course will be in jurisdiction of Switzerland/Italy, and all the cost
will be responsibility of student themselves.
Online course material sent will be copyright of school and may not be reproduced without written permission
of school authority.

Declaration by Student:
I ....s/o, d/o, w/o .
I have read and understood the various terms and conditions regard to admission to this course. I had been given enough
opportunity to answer about my queries by authority of MPR International School and other organizers of this course. It is
my own decision to get enrolled to this course.
I also declare that I have no criminal background and there is no criminal/court proceeding against me pending in court in
the any court in India or other part of world.

Signature of Student: ...Date: