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1
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Ensure you
have read the
refund policy.
Please complete form
legibly |
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2
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Insert cost alongside event(s) for
which you are registering
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▼ |
3
▼ |
Circle event number under relevant venue |
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Wellington |
Hamilton |
Christchurch |
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Primary Certificate in REBT |
$1012 |
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1001WN |
1001HM |
1001CH |
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| |
WShop: Anxiety Disorders |
$224 |
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1002WN |
1002HM |
1002CH |
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| |
WShop: CBT with Children & Fam. |
$198 |
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1003HM |
1003CH |
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WShop (2 days): Mindfulness |
$356 |
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1004WN |
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1004CH |
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TOTAL enclosed: $ |
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NB: GST of 12.5% is already included
in all fees
(GST# 36-715-731) |
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4
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Complete Payment Details:
▼ |
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□ |
Cheque (payable to ‘Rational Training Resources’) enclosed. (Post
form to: PO Box 2292, Stortford Lodge, Hastings, New Zealand) |
If you would prefer to pay by direct
bank transfer, please contact the Centre |
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□ |
Please charge credit card as below (form may be posted, or faxed to
64-6-870 9964): |
| |
Card No: __ __ __ __ / __ __ __ __ / __ __ __
__ / __ __ __ __ VISA / MASTERCARD
(circle).
Name on Card (block letters): ________________________________
Expiry Date on Card: __ __ /__ __
Amount: $ _________________ Cardholder’s Signature:
_____________________________________ |
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Name: |
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Phone
(show STD)
-
Day:
Evening:
Fax: |
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E-mail:
(will enable us to keep you informed): |
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Address: |
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Profession: |
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Current position: |
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Qualifications
(required for Certificated
courses):
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How I heard about these programs: |
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Signed:
Date: |
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LINKS TO OTHER TRAINING PAGES
·
Main listing of training events
·
Instructions & notes on registering
·
Registration form
·
Printable brochure (PDF format)
·
Participant's Information sheet (locations, times, etc.)
·
Registration form
·
Training venues
NB: Information on this page is subject to change without notice. |