Unleash Part 2 Booking Form

Given Name *

Family Name *

Email *

Enter Email

Confirm Email *

Confirm Email

Phone - ideally mobile. Note that this needs to be entered without spaces. Please include your country code (eg +44 for UK, +1 for US/Canada, +61 for Australia etc.) *

Have you already completed Unleash Part 1, or firmly booked to do so before doing Part 2?

Yes

No

Please confirm when you either did or are doing your Unleash Part 1. Note that colleagues may register for Unleash Part 2 only after they have completed Unleash Part 1, or are firmly booked to do this before joining Part 2.

For Unleash Part 2 (Intergenerational, Dreams, Parts intro), please choose from the following dates. Note that you cannot join Unleash Part Two before you have completed Part One. All workshops £456 (or local currency equivalent).

Level of EMDR Training - Note that you cannot join our workshops/webinars unless you are fully trained in basic Standard Protocol EMDR. *

At least Part 3 (Part 2 in AU/NZ/US)

Accredited Practitioner

Accredited Consultant

Accredited Trainer

OtherOther

Where are you registered for tax purposes?

How did you hear about this Workshop? *

By registering for an EMDR Focus workshop, and recognising that participation can involve both observation and personal experience of sometimes profound trauma processing, I agree to take appropriate responsibility for my own emotional wellbeing, and to ensure I have access to any necessary therapeutic and/or supervisory support following the workshop. *

Yes

No

By ticking the Yes box below, I acknowledge that in managing this list, EMDR Focus Ltd will observe all requirements of GDPR.

Yes

No

Payment Options

I will pay immediately using credit/debit card, please take me to the necessary page.

I need a separate invoice for the organisation paying for this.

I wish to pay in instalments (by prior agreement only)

If requesting to pay in instalments, some words of explanation.

Credit Card