Essentials of Sexual Minority Therapy
Application Form

Please print this form out and post it in to us.

Please reserve me a place on the Essentials of Sexual Minority Therapy five day course on:
4 & 5 Oct, 25 Oct, 22 Nov, & 13 Dec 2008 OR 17 Jan, 21 Feb, 21 March, and 18 April 2009 [please delete whichever is not applicable]

If you are booking for individual days, please use this form here

Name:___________________________________ Email Address:_______________________

Postal Address: ______________________________________________________________

___________________________________________________________________________

Postcode:____________________________

Telephone No:________________________Home
Telephone No:________________________ Work
Telephone No:________________________ Mobile

I am/am not a member of the Directory of Pink Therapists (please delete as applicable)

Occupation:____________________________ Theoretical Model: ______________________


I enclose a cheque payable to: Pink Therapy for £450

Signed: _____________________________ Today's Date: ____________________________

Please post this form, along with your fee to:

Dominic Davies
Pink Therapy
Flat 3
3-4 Archer Street
London
W1D 7AP

Terms and Conditions
Fees: The full fee for this course is £450. Cheques should be made payable to Pink Therapy in GB sterling. Payment must accompany all orders, and we are not able to invoice you.
Receipts: A receipt will be sent along with your booking confirmation and details of the venue.
Cancellations: There is an administrative charge of £15.00 per person for cancellations received in writing up to one month prior to the first date of event. Thereafter no refund is possible.
Indemnity: This booking constitutes a legally binding contract. It may be necessary, for reasons beyond the control of PInk Therapy to change the programme, speaker, date or venue. In the unlikely event of a programme being cancelled, a full refund will be made, but Pink Therapy disclaims any further liability.
To change a delegate, please call at least seven days prior to the event.