Application to participate in experimental hypnosis

Thank you for considering to take part in the Trance Depth Experiment.  Your details will not be disclosed to any party without your expressed permission and client details will be withheld in all instances.

We welcome participation to be conducted by qualified Hypnotherapists with their chosen subjects and require that each set of questions be returned to Hypnotic World shortly after each experiment is carried out.  The closing date for completion of our statistics is 31 December 2005.  The collated data will be presented to Mr Andrew Moore for analysis.

Please complete the form (below) and return to info@hypnoticworld.co.uk

We will notify you of the outcome of this experiment when it is complete.

Name _______________________________________________________

Address______________________________________________________

_____________________________________________________________

Telephone Number(s)____________________________________________

Email Address __________________________________________________

Qualifications __________________________________________________

Date __________________________________________________________