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Personal Details
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First Name
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Address
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Professional Details
Current professional role. Include any area of specialisation.
Private practice or the organisation you work for.
Please describe any psychological, counselling and/or somatic models you have trained in, including touch, bodywork and/or movement modalities. Include if you have a mindfulness, meditation, yoga practice or any other approach where you may track internal experience.
Please tell us your interest in the NeuroAffective Touch® training and how you think it will benefit you.
Payment Options
Super Earlybird $2,730
Initial deposit of $660 due within 7 days with payment balance of $2,070 due by 30th January 2021
Super Earlybird Payment Plan $2,807
First instalment due in month of application, followed by regular monthly or fortnightly instalments.. 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)
Upon acceptance of your enrolment you will receive an email with an invoice attached plus information on how to make payment.
Comments and Queries
If there is any other information you wish to provide or if you have a query then please enter it here.
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PRIVACY POLICY: We acknowledge that your personal details are confidential and they will not be shared with or sold to any third party.