Booking form for Online EFIT Consultation: Mastering Skills and Overcoming Challenges, 12th and 26th October, 2024

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Please complete this form and submit it. Many thanks from your ICEEFT Certified EFT trainers: Helene Igwebuike, Sarah McConnell, and Robert Allan.

Email *

Name (as you would like it to appear on certificate of completion) *

Address *

Phone number (preferably mobile/cell number) *

Have you completed 4-day EFIT Essentials or EFIT Level 1 and 2:
*

Yes

All of these must be ticked. If you have any questions about this please contact us. *

I am a licensed mental health therapist or counsellor or a member/student member of a recognised counselling/professional mental health organisation. This license or professional body should have a code of ethics that you are bound by. It should also be a licensing body or recognised body that has a membership of mental health professionals or students. It should require that you have a mental health qualification that will qualify you to be a mental health counsellor or psychotherapist (or are studying for one) in order to join.

I want to develop my understanding of Emotionally Focused Individual Therapy.

I agree to not record any part of this training in any format (audio, video, or visual). Personal written notes of non-confidential material are permitted.

I agree to keep confidential the personal identifying information of case material shared in the training.

I will inform a member of the training team if I recognize any person on audio/video and understand that I will need to leave the room during the time that this person / persons are being discussed.

Required

We will have up to 6 different participants presenting their case with the trainers doing a consultation with the presenter.

Are you in interested in presenting?

Yes

If yes, in 2-3 sentences, tell us about the case or about your caseload in general:

Where did you get to know about this training? *

Payment Options (UK and European registrants or those who wish to do an international transfer)

By bank transfer [Please use your full name above as payee reference]: Account name: Emotionally Focused Training Ltd, Barclays, Account number 70179094, Sort Code 207690

By International Transfer: IBAN: GB92 BUKB 2076 9070 1790 94

Please invoice me via QuickBooks (see below)

Payment Options, $395USD (USA, Canada, and those wishing to pay by credit card - note that USA based registrants may also pay directly from a bank account via this means)

Please invoice me via QuickBooks to the following email:

QuickBooks name and email address:

Venue

Online via Zoom

Times

12th October, 1-6pm, UK time

26th October, 1-6pm, UK time

CONSENT TO RECEIVE EMAILS

Please check the appropriate box to consent/not consent to receiving emails from the ICEEFT – The International Centre For Excellence In Emotionally Focused Therapy.

I agree to receive occasional email communications from ICEEFT. These emails will provide information about new EFT resources, future learning opportunities, and/or important community news. I understand that I can unsubscribe at any time by clicking the link in the footer of ICEEFT’s emails. I understand that ICEEFT will not share my information with any third parties without my consent.

I do NOT agree.

For enquiries:

Robert Allan: drrobertallan1@gmail.com

Helene Igwebuike: heleneigwebuike@gmail.com

Sarah McConnell: sarahmcconn@gmail.com

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