2nd Annual Open Space Day Registration Form

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Thank you for your participation. Please complete the following questions and make the payment via the banking details provided below. We look forward to seeing you on the 30th of April!

Location of Open Space Day:
Via Zoom, link to be shared after registration

Email *

What is your name? *

What is your occupation/title? *

What is the location of your practice (e.g., Geneva, Zurich)? *

What is the scope of your practice (e.g., adults, mood disorders)? *

If you have a website for your practice, please feel free to share the link below.

Would you like your information (name, contact information, photo and a short description of your practice) to be included on a registry of English-Speaking clinicians that we are creating? *

Yes, please include me on the registry

No, I prefer not to be included

I would like to learn more before I decide (we will email you)

Are you interested in presenting a workshop at the Open Space day on 30 April? *

Yes

Maybe

If you're interested in presenting a workshop, please provide a short description below, including the proposed length of the workshop (30 minutes, 45 minutes or 60 minutes).

Did you participate in Open Space Day last year? *

Yes

No, this is my first time

Please confirm your registration by paying the 75 CHF registration fee via the following e-banking information: IBAN CH51 0079 0042 9408 9934 8 En faveur de: Elizabeth Frei Orange Arbor Psychology Center Oberer Quai 12 2502 Biel/Bienne Compte: 30-106-9 Berner Kantonalbank AG *

I have paid the fee

The cost is a barrier to me joining this event (we will contact you)

Thank you for your interest and registration! A confirmation will be sent to you shortly. Please feel free to leave us any other comments or questions.

A copy of your responses will be emailed to the address you provided.

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