Oz/NZ Booking Page 2027 (2)3.3 Australia/NZ 2027 Booking Form NEW Given Name * Family Name * Email * Enter Email Confirm Email * Confirm Email Mobile/Cell phone – please include your national code (+61, +64, +44 or other…). Please enter with NO SPACES. * What’s your level of training in EMDR? * Basic Foundational Accredited/Approved Practitioner AccreditedApproved Consultant EMDR TrainerWhich workshop would you like to book/register for? * Perth (Jan 22–23, 2027) — with full catering A$695 Sydney (Jan 29–30, 2027) — with full catering A$695 Melbourne (Feb 5–6, 2027) — A$625 Auckland (Feb 12–13, 2027) — NZ$595 Brisbane (Feb 18–19, 2027) — with full catering A$695How familiar are you already with Mark’s model of attachment-informed EMDR (ai-EMDR) * I already live and breathe this stuff I’ve done some basics with Mark, but still fairly green I’m keen on EMDR, but specifically attachment-informed is new to me Just curious If you’ve already done a workshop/webinar with Mark, tell us a bit more * Any dietary requirements or allergies? * Lunch is included for Perth, Sydney and Brisbane. Melbourne and Auckland delegates source their own from nearby. If you have allergies or specific requirements we should pass on to the catering team, please let us know. Any access requirements or adjustments that would help us welcome you well? Anything we can do to make the workshop work for you. Optional. In case of emergency on the day, who should we contact? Name and phone number for someone we could reach if needed. Doesn’t need to be next of kin.Payment options… * I’m happy to pay the full price for the workshop I’ve chosen I’d like to ask for a concessionary rate A few words about your situation, to help us think about it * To whom should the invoice be made out * To myself personally, as named above. To my organisation, who are paying for this. What’s the name of your organisation? * Where are you registered for tax purposes? * AustraliaNew ZealandUKUSAOther Where are you registered for tax purposes? What I’d really like to get out of this workshop is….. (Optional) Might you like in principle to volunteer for one of the live sessions with Mark? (Optional) You must be joking! Not in a million years. I might just consider it, but won’t insist. Recognising that a Yes here won’t necessarily mean being selected on the day, definitely put me down in principle as keen.If we’re able to livestream these workshops would you be interested in either live attendance online or in a recording? Intend to be there in person If the workshops are live-streamed, I would like to join online I might be interested in recording-onlyA note on the nature of these workshops, and a few practical agreementsOur workshops involve live demonstration of EMDR with real personal material, and paired practice work on focused elements of the work (not full sessions). This can take you into challenging territory.We commit to running the room with care. We ask you in turn to take responsibility for your own emotional wellbeing during and after the workshop, to have your own therapeutic and supervisory support in place around the dates, and to engage constructively with whatever comes up for you and for those you work with.By registering, you also agree that EMDR Focus may store the personal information you’ve provided for the purpose of administering this workshop and future EMDR Focus communications, and that any recordings made during the workshop will be available for review only by registered participants and only for the period agreed at the workshop itself. Volunteers for live demonstration work will be asked separately for their explicit consent before any recording.You’ll be added to the EMDR Focus mailing list, from which you can unsubscribe at any time.I have read and agree to the above. * YesSubmit If you are human, leave this field blank.
