Civic Mediation Theory & Practice Course 2022 - Registration Form
Course Dates: Days 1 & 2: Tuesday 10th May - Wednesday 11th May; Days 3 & 4 Tuesday 24th May - Wednesday 25th May; Day 5 Online input Wednesday 8th June. Days 6 & 7 Tuesday 21st June - Wednesday 22nd June.
Course Timings: 10:00 - 16:00 each day. Online input involving 4 hours contact time via zoom.
Venue: The Bay Hotel, Burntisland Road, Kinghorn, Fife, KY3 9YE.
Support: If you need any help completing this form, please contact Abdul Rahim on 07960 683328 or by email: abdul@centreforgoodrelations.com

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Title: *
Full Name: *
Organisation (if applicable):
Address: *
Email address: *
Telephone Number: *
What is your motivation for attending this course? (Max 200 words): *
Please describe any previous experience you have of mediation/facilitation including any training courses attended (Max 200 words): *
Please provide a short biography (Max 200 words): *
Do you have any specific dietary requirements? *
Do you have any specific access requirements? (Is there anything that we could put in place to make it easier for you to attend this course?) *
Thankyou for taking the time to complete this form. We will be in touch shortly to confirm your registration.
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