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Application Form For Fellowship. Of WNHO ONLINE DISTANCE LEARNING COURSE IN SEXOLOGY/COSMETOLOGY /PREVENTIVE CARE INSTITUTE OF COMPLEMENTARY MEDICINE(ICM) Affiliated-IBCM-INTERNATIONAL BOARD OF COPMLEMENTARY MEDICINE & GLOBAL EDUCATION(WNHO) AUTONOMOUS EDUCATIONAL TRUST REGISTRATION NO.382/11985GBBSD BPT 1950F-10581, MUMBAI. Run by Govt. Certified Startup. WNHO Health Care Pvt. Ltd. APPLICATION FORM I wish to apply for online certificate courses Fellowship in Sexology and Psychosexual medicine. Or Fellowship In Other Subject….Preventive Health/Cosmetology/Yoga & Health/Psychology/Physical Fitness. Name-............................................................................................................. Age ....................... Qualification Address........................................................................... ......................................................................................................... ............................................................................................................. ............................................................................................................. Date of Birth-...........................................Mob-.............................................. Email-.................................................................................. DECLARATIONS. I hereby declare that the above information is true. I have read the rules of discipline. I agree to fully abide by them and also rules made by the authorities of the institute from time to time. I know that fees once paid will not be refund or transferred on any account. Fees Rs 30, 000 + 18 % GST + 1-3 days Hands on training Exam & Certification & Awards…. Rs-12000/ Attached your scan copy of Graduation for eligibility letter with Invoice for course. Signature of student. Address Course Co-Ordinator WNHO clinic, Sadashiv Peth, Opp ICICI Bank, 3 Dhanwantari Building, Tilak Road, Pune-411030 , Mob-9822006427 Email:drrameshm2@gmail.com/ cc to wnhohealthcarepvt.ltd@gmail.com