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BOOKING FORM – CPD COURSES 2009/2010
PLEASE TICK YOUR CHOICE(S):
Mindfulness - An Approach To Help With Anxiety
Sat 28th November 2009 ( ) or Fri 8th January 2010 ( )
Child Protection for Counsellors Sat 9th January 2010 ( ) or Fri 22nd January 2010 ( )
Understanding Drug Use And Dependency (Part 1)
Fri 5th March 2010 ( ) or Sat 6th March 2010 ( )
An Introduction To Cognitive Behavioural Therapy
Fri 26th February 2010 ( )
Understanding Drug Use And Dependency (Part 2)
Fri 19th March 2010 ( ) or Sat 20th March 2010 ( )
Introduction To Counselling Assessments Wed 10th March 2010 ( )
Mindfulness - An Approach To Help With Depression
Fri 16th April 2010 ( )
An Introduction To Mental Health Sat 24th April 2010 ( )
An Introduction To Person Centred Counselling
Fri 30th April 2010 ( )
Please use BLOCK CAPITALS. One form per person. Photocopy this form is required.
Title_______ Name________________ Surname_______________________
Address___________________________________ Post Code____________
Home Tel:______________________ Mobile Tel:_______________________
E-mail address__________________________________________________
In What professional capacity will you be attending the workshop(s) e.g. Counsellor
Social worker, Nurse etc ____________________________________________
Name of the organisation you work for (optional) __________________________
How/where did you hear about the workshop(s)? _________________________
DAYBREAK Terms and Conditions. Payment is refundable if a cancellation is made
more than 14 days before the event. DAYBREAK reserve the right to cancel an event
at any time due to unforeseen circumstances or low numbers, in which case a full
refund will be made.
I agree to the above conditions and enclose a cheque (payable to DAYBREAK DRUG PROJECT)
for: £___________________ to cover full costs of the workshops/courses as stated above.
Signature______________________________________________ Date________________
Please return your form to: Daybreak Counselling and Training and Service
St Luke's Daybreak Centre
Dagenham Road
Dagenham
Essex RM10 7UP
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