APAC Introductory Course Application Form

This course has been accredited by PTUK

Course: An Introduction to Play Therapy (One Day)

Please complete the form below, either on-line or alternatively print it out, complete it then post it to Monika Jephcott, APAC, The Coach House, Belmont Road, Uckfield, East Sussex TN22 1BP, England.

Please also send a cheque for £110 made payable to APAC

You must complete the information marked *

Thank you.

1st Name *

2nd Name *

Address *

Town/City *

Postcode *

e mail *

Phone *

Other phone

If you have worked with children, please describe your experience:

Please state your main learning objectives - what you'd like to get out of the course:

Prior Relevant Training (This information enables us to tailor the day to participants' experience). Please list up to 4 courses in reverse chronological order.

Date of Course

Training Provider

Course Name

Award

Date of Course

Training Provider

Course Name

Award

Date of Course

Training Provider

Course Name

Award

Date of Course

Training Provider

Course

Name Award

Residential

Please tick if you wish to be residential for the evening prior to the course.

Please click the Submit button when you are ready to send your application or enquiry. Use the Reset button if you want to start again - it will clear all the information you've typed.

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