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Advanced Holistic Counselling & Psychology Course Registration Form
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1.
Name of Course
(Required.)
Advanced Holistic Counselling & Psychology
2.
Scheduled Start Date of Course (Month & Year)
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3.
Contact Information
(Required.)
Name
*
Address
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Address 2
Country
Email Address
*
Phone Number(s)
*
*
4.
Gender
(Required.)
Male
Female
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5.
Age Range
(Required.)
Under 20 years
20-29 years
30-39 years
40-49 years
50-59 years
60-69 years
Over 70 years
6.
Field of Employment
7.
Church/Organisation
*
8.
Kindly indicate which admission requirements have been met (select at least one)
(Required.)
GCSE or CSEC Pass(es)
Training in Ministry, Counselling, Psychology or related field
Proficiency in Reading & Writing
Recommendation from Church/Pastor or Organisation
9.
How did you hear about this course?
Church/Pastor
Relative/Friend
Email Marketing
Nation Newspaper
Radio
Other (please specify)
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10.
What do you expect to gain from this course?
(Required.)
*
11.
How do you plan to use the knowledge gained?
(Required.)
12.
Date of Application
Date / Time
Date
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Your registration form will be processed and Grace & Truth Critical Incident Training & Consultancies will contact you with further information.