Workshop Registration

Registration Form
All training workshops are consecutively attended after Module 1.

Name of Workshop:

An Introduction to CCPT (Module 1)

Module 2

Module 3

Module 4

Module 5

Module 6

Module 7

Location:

Houchen Retreat House, 83 Houchen Road, Melville, Hamilton

Food:

Catered finger food lunch @ $45 incl. GST

Dietary Preferences:
Payment:

Name:

Postal Address:

Home Phone:

Mobile Phone:

Work Phone:

Email:

Occupation / Professional Training / Current Study:

Cost:

Note: Early-Bird rate if paid 4 weeks before workshop date

Total Payment for Workshop:

Estimated Payment Date:

Payment Method:

Direct Bank Deposit

Please include your name or agency on the deposit details.

Cheque

Postal Address:

Childplayworks Ltd
189 Kahorekau Rd
RD7
Te Awamutu 3477

Automatic Payment

Amount:
Frequency:

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