First Name
	Last name
	Address
	Address
	Post code/zip
	Country
	Telephone
	Email

	Note: We don't give anyone information about our students. And we will only cash your check after your course has been despatched.  I enclose cheque/PO made payable to The Institute of Copywriting, for US $473. Want to pay by credit card? Click here. Our terms and conditions.
	If enrolling by post, please send this form to: The Institute of Copywriting Honeycombe House, Bagley Wedmore, Somerset BS28 4TD, UK Tel: 01934 713563 Outside the UK, phone +44 1934 713 563 Email: The Institute of Copywriting The Institute of Copywriting 1133 Broadway, Suite 706 New York, NY 10010-7912 USA Toll-free phone 1-888 453 0546 Email The Institute of Copywriting
	Please tell us a little about yourself. This helps us understand your needs better. We'll treat your answers in the strictest confidence. What is your aim in taking this course?   How did you learn about the course?  Advertisement (which publication?)  Editorial (which publication?)  Friend, colleague or relative  Internet (which directory or search engine?) ______________________________________ Other source (please specify) What newspaper(s) do you read regularly (if any)? What magazines do you regularly read (if any)? Do you have any interests or hobbies? Do you have any of the following to help you with your studies? (Don't panic - you don't need them for the course!)  Video recorder  Fax  Email  Computer  CD-Rom  DVD player  Internet access What is your current or most recent occupation? What education have you attained in the past?  High School  Degree  Professional qualifications Your date of birth Thank you for taking the time to complete this questionnaire.