Registration form
Online CBT-E for AN Masterclass (1 day)

Name *

First Name

Last Name

Professional registration *

Registered Clinical Psychologist

Registered Psychologist (Health/Counselling)

Registered Psychologist (other- please detail below)

Registered Psychotherapist

Registered Psychiatrist

Other (please provide details below)

Approximate number of clients with eating disorders you have worked with *

We ask this information in order to ensure the training is targeted at an appropriate level for participants

No experience yet

1-2 clients

2-5 clients

5-10 clients

10-20 clients

20+ clients

I will be joining from *

North Island

South Island

Australia

Other

I will be paying by *

An invoice will be emailed to you following receipt of your registration. Payment is due in full by 4 weeks prior to training date please, in order to secure your place. In the case of cancellation due to COVID lockdown, the training will be either shifted online or rescheduled, with your registration transferred to the new date. A full refund will be an option. A full refund will be offered if you cancel >4 weeks prior to training, 50% refund if cancelled <4 weeks prior to training.

Bank transfer

Credit card (2.5% fee surcharge)

Invoice to workplace (this will be emailed to you, to forward on & arrange payment as appropriate)