Register-Non-Directive

Registration Form

To register for the “Introduction to Non-Directive Play Therapy (One Day Workshop)”, please use the form below. The fee for this course is £110.00 and is payable either by cheque, invoice or PayPal.

* denotes required data


Course

Date


First Name *		Surname *
Profession *		Organisation *
Phone Number (Day) *		Phone Number (Evening)
Fax		Email *

Address Line 1 *		Address Line 2
Address Line 3		Town
County		Postcode

Emergency Contact Name *		Emergency Contact Number *

Where did you hear about us?

Payment Method*	PayPal	Credit/Debit Card	Invoice
Any other info, special needs, etc.

Your Training History

Date of Course	Training Organisation	Course Name	Qualification Obtained

I have read the Terms and Conditions

Your email address will be added to our mailing list. If you do not want this please tick

During the workshop we may take photographs to use for marketing purposes. If you do not want this please tick

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