The National EducationAlliancefor PersonalityDisorder (NEA-BPD)NewZealandBranch
and ADHB Mental Health Services
Registration
Date: / Thursday 16th and Friday 17th November, 2017
Time: / 9:00am – 4:30pm
Registration: / From 8:30am
Venue: / Liggins Theatre, Level 1, Building 16, ADHB Greenlane
Access: Main Greenlane Clinical Entrance, 214 Greenlane Road, Greenlane
also from Claude Road. (see map link -
Cost: / $100.00 includes training materials, morning and afternoon tea (free for family members)
Lunch: / BYO or café on Lower Ground Floor of Building 16, Jamaica Blue Café and Café Espresso on site in main Greenlane Clinical Centre
To Register please complete this form.
Invoicing and payment information will be sent to you by email.
Please complete all fields and tick box that applies.
Name: / ......
......
Email address:
Your role: / I am a family member
I am a registered mental health professional
I am an NGO family/whãnau support worker
Phone: ......
Your organization: ......
Name of Family Connections training partner ......
Is your Family Connections training partner also attending?
My training partner WILL be attending on 16th and 17th November
My training partner WILL NOT be attending on 16th and 17th November
My training partner has previously attended a Family Connections training (give details of previous attendance)
I agree:
That I have attended a Family Connections program as a participant (not leader)
If I have not attended a Family Connections program as a participant (not leader) I have Roy Krawitz’s permission to attend
To run a Family Connections program starting in 2018
That I have the support of my organisation/service to be a Family Connections Leader and to co-facilitate a group in 2018
To run the Family Connections program as it is manualised (i.e. adherently, not adapted - unless obtained permission from Roy Krawitz prior to registering for the Family Connections Leaders Training)
To providing Family Connections programs free of charge to participants (except for costs of materials and venue hire where applicable)
That my 2018 Family Connections Co-Leader will be attending the 2017 Family Connections Leaders Training or has attended a previous Family Connections Leaders training with Roy Krawitz or Alan Fruzzetti.
If you have any queries with completing this form please contact Leigh Murray by email, or phone 021 938 226.