AMA ROI Student License Application

INSTRUCTIONS ROI STUDENT SUBMISSIONS

Student registrations to be processed by instructor only 

  1. Complete the club and instructor details
  2. Enter the club size when asked
  3. Enter how many students between 1 – 12 you would like to submit in this single session.
  4. Complete student entries 1 – 12 (as selected).
  5. Submit Registrations & Pay
  6. The confirmation screen will have your block license(s) for downloading. These will also be emailed using the email address entered into the form.
  7. Please do not copy and paste.
  8. Let’s Get Started

Please note that we use PayPal as a payment provider. You do not need a PayPal account, You can pay by credit or debit card just like any other payment provider.

For technical support, please take a screenshot of the error and email greig.thomson@ossianmedia.co.uk in the first instance.

AMA 1-12 ROI STUDENT LICENSE FORM

Club & Instructor Details

Instructor Name
Instructor Name
First
Last
How many ROI students will you register now?
You can submit up to 12 registrations at any one time.

Student 1 Details

Student 1 Name
Student 1 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 2 Details

Student 2 Name
Student 2 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 3 Details

Student 3 Name
Student 3 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 4 Details

Student 4 Name
Student 4 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 5 Details

Student 5 Name
Student 5 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 6 Details

Student 6 Name
Student 6 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 7 Details

Student 7 Name
Student 7 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 8 Details

Student 8 Name
Student 8 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 9 Details

Student 9 Name
Student 9 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 10 Details

Student 10 Name
Student 10 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 11 Details

Student 11 Name
Student 11 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Student 12 Details

Student 12 Name
Student 12 Name
First
Last
From Age 4 to 65 (Public liability), 80 (Personal Accident)
PLEASE NOTE: Can not be backdated - Can be forward dated for up to 1 month only.

Payment

Total Due Today