Application form Couples Therapy Training

Name

 

Address

 

Suburb

 

postcode

 

Phone 

 

Mobile

 

Email

 

 

 I enclose $380 Couples Workshop Peregian Beach Qld

 

 

Make all cheques payable to : Brian O'Neill

 

Post to PO Box 141 Peregian Beach, Queensland 4573

 

or

 

Direct Deposit

 

St George Bank

 

Account Name: Brian O'Neill

 

BSB:                   112-879

 

Account:   152 755 963

 

Refund Policy

To secure a place the full amount is due . Cancellation prior to 14 days before the commencement of the workshop will be given a  refund subject to a cancellation fee of $25 dollars. No refunds will be provided after that.