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.