Part A: Applicant Information

Name:
D.O.B:
Gender: MaleFemale
Company/Organization:
Job Title:
Email:
Mobile Phone Number:
Office Phone Number:
Experience/Training Background:
Reason(s) for attending:

Part B: Courses you wish to Enroll

1. Early Attachment Course 2 Days Training Course (SGD$700)
2. Parent-Child Attachment Play 2 Days Training Course (SGD$700)
3. Heart to Heart 1 Days Training Course (SGD$350)
Both Early Attachment g & Parent Child Attachment Play Courses (SGD$1200)
Both Early Attachment & Heart to Heart Courses (SGD$900)
Both Parent Child Attachment Play & Heart to Heart Courses (SGD$900)
All of 3 Courses (SGD$1500)

Total amount payable:

Part C: Mode of Payment

Please choose:

Cheque made payable to "Creative Play Therapy"
Send to: 231 Mountbatten Road, Block D, #02-04 Singapore 397999
Direct bank transfer or ATM (keep payment slip)
Make your payment directly to:
DBS Bank Ltd Singapore (Head Office)
12 Marina Boulevard, Tower 3
Marina Bay Financial Centre
Singapore 018982
Account Name: Creative Play Therapy
Account Number: 1049010864
Swift Code: DBSSSGSG

Please inform Marina via email when you have transferred the course fee(s).

Please feel free to contact Marina Lim at Creative Play Therapy if you have any enquires.

Please note that submission of a completed registration form constitutes a firm booking, subject to the following terms and conditions. Any cancellations received after 1st November 2016 will incur an administration fee of SGD$100. Cancellations must be made at least 15 days before the start of the course begins. If delegates are unable to attend for any reason that is beyond the control of the organizers, such as transport problems, personal illness, bereavement, inclement weather, terrorism, or Act of God, it will not be possible to make any refunds of workshop fees.

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