Booking Form

Intermediate Day Course 3 March 2012

Communication Skills 20 April 2012

Conflict Management and Mediation Skills Training 14-18 May 2012

Introduction to Conflict Management 2-4 October 2012

Mediators Basic Training 16-18 October 2012

Conflict Management and Mediation Skills Training 19-23 November 2012

Intermediate Day Course 10 November 2012

Your name:

Address:

Occupation:

Email address and 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).

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