Registration COPCA® module

Please note that your enrolment is binding.

The course material is included in the course fee and provided in electronic form. The purchase of further specific technical literature is optional and at the expense of the student.

Personal data

Participant*

Family name, first name *

Address *

Adresszusatz

ZIP Code / City *

Phone No. *

E-Mail address *

Date of birth (DD.MM.YYYY) *

Hometown / Nationality *

Profession *

Invoice address

To which address should the invoice be sent?*

Private address

Employer*

*If your invoice is to be sent to your employer: please enter the appropriate invoice address below.

Qualifications and Requirements

Degree*

a Bachelor of Science (BSc) degree (from a university of applied sciences, a university or a degree title conversion

a degree from a college of higher education and training

another degree

another degree, namely

Requirements*

I have completed the course “Normal Development of the child” or I have equivalent previous training (Plaese provide the confirmation)

I have completed the course “Infant Motor Profile” (Please provide the confirmation)

I work in the field of pediatric physiotherapy and have access to the treatment of infants and young children.

CampusCard

Note: Only one active CampusCard is allowed per person. An existing card will be blocked if a new free-of-charge card is to be issued. If a replacement card has to be issued, the applicant will be charged an administrative fee of CHF 50.*

I would like to order a CampusCard for free.

I already have a CampusCard and would like to continue using it.

Remarks

Please enter your comments here

Personal information

I agree...*

that my personal information will be used in connection with this continuing education course. (To be included in course list for distribution to participants and teaching staff, on mailing list for information on further courses available)

Use of your data

I allow ZHAW to include my contact information in the ZHAW mailing list for internal promotional purposes during and after completion of the continuing education course. No contact information will be given to third parties.

Confirmation

General Terms of Admission and Participation for Continuing Education Courses and Programmes

I confirm...*

that I have read and agree with the General Terms of Admission and Participation.

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