Booking Form

Mediators Basic Training 16-18 October 2012 Beachcroft

Conflict Management and Mediation Skills Training 22-26 October, Coventry

Conflict Management and Mediation Skills Training 19-23 November 2012 Pickwell

Workplace Top Up Course 10 November 2012 Beachcroft

Introduction to Conflict Management 29-31 January 2013

Mediators Basic Training 12-14 February 2013

Your name:

Address:

Occupation:

Email address

Phone number

Special requirements: (dietary/access)

Are you here at your own request?

Are you here at your employer's request?

I confirm I will send my non-refundable deposit of £200 (for mediation skills training courses)

Agree to pay the balance of the full course fees four weeks before the start date

I acknowledge that if I cancel within six weeks of the start date, the full course fees will be payable to Peaceworks

Please tick if you are paying for your course

Please tick if your employer is paying for the course

We will contact you to discuss your application and what you hope to achieve from the training