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Personal Details
First Name
Last Name
Email Address
How did you hear about this event?
Professional Details
Current professional role. Include any area of specialisation.
Private practice or the organisation you work for.
Please give a brief description of your professional background and any current work specialisation. Also include if your work involves helping others to process psychological issues and list any relevant training or education.
Please give a brief description of how your current work involves the body and any training, education, or practice you have that involves the body.
Dietary Requirements
Special Dietary Requirements
Vegetarian Plus Fish (Pescatarian)
Vegetarian (No Fish)
Gluten Free
Dairy Free
Other (Please specify)
Payment Options
Earlybird $2,310
Initial deposit of $660 due within 7 days with payment balance of $1,650 due by 30th January 2020
Earlybird Payment Plan $2,387
First instalment due in month of application, followed by regular monthly instalments with the full balance due by 6th February 2020. Please advise your preference for the no. of instalments in the comments box below.
Payment Method
Pay by Bank Transfer
Pay by Credit Card - fee of 1.75% applies (2.9% for overseas cards)
Information on how to pay will be detailed in your application confirmation email.
Comments and Queries
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