EMDR Liverpool Training Application Form

EMDR Liverpool Training Application Form

EMDR Liverpool Training 2017 Application Form

Your Details

Mailing Address
Contact Telephone
number (day)
Contact Telephone
number (evening)
Place of Work
Type of Work
Core Profession
Professional Body &
Membership Number
Special Dietary Requirements
Access Requirements
Please tell us how you heard about our training
Training / Fee / Application Closing Dates
Invoice to Funding Body / Other payment methods
**Special Offer**
(For both Levels paid together, inclusive of free Consultation/Supervision Day) / £1400 / 29th December 2016 / 9th February 2017
Payment to be sent with application. We accept
Cheque, postal order, Invoice to funding body *complete Invoice details in form below and provide supporting letter from funding body.
We are also able to take BACS payment – please contact Mersey Psychotherapies for relevant details.
If you would like to discuss individual training levels and costing, or have already part completed EMDR Training, please contact Mersey Psychotherapies and we would be happy to discuss this further.

Invoice to Funding Body

Invoice to funding body (Please include a letter from your funding body agreeing to pay your fees one month prior to commencement of training.

Please note, your place is only confirmed once your payment has been received and will not be guaranteed with an application form alone.If your funding body does not complete payment one month prior to the start of the training, the applicant will be liable for the training fees.

Purchase Order Number
Billing Name
If this is a finance department you MUST obtain the Purchase Order and correct billing name and address. Failure to do so could delay payment of your course fees.

Cancellation Policy

The registration fee will be refunded minus a £100 cancellation charge if cancellations are received in writing to Mersey Psychotherapies, Office 1, The Foundry, Marcus Street, Birkenhead, CH41 1EU prior to two weeks before the date of the training.

Cancellations within two weeks of the event date are charged the full registration fee, other than in exceptional circumstances which can be verified.

In the unlikely event of the training being cancelled for reasons outside of our control, Mersey Psychotherapies will not be liable for travel and/or accommodation costs incurred. However the registration fees will be refunded.

Replacing delegates - If a delegate is unable to attend and an eligible replacement is nominated there may be a charge depending on the individual circumstances, this will be advised at the time. Please contact Mersey Psychotherapies to discuss this at least a week before the training start date.

By applying for the training you are agreeing to the cancellation policy.

Completed applications

Please mail your completed application form with appropriate payments to;

Mersey Psychotherapies,

EMDR Training Applications,

The Foundry,

Marcus Street,



CH41 1EU.

Should you have any further details please contact Mersey Psychotherapies on 0151 345 0430 or via email

Thank you for your application. We look forward to meeting you soon. Once all funds have been secured, we will contact you regarding further training arrangements.