Mindsync and PsycGlobal EMDR Foundation Training

Name

First Last

Address

Street Address City State / Province / Region ZIP / Postal Code Country

Place of work

Phone

Email(Required)

My core mental health profession is:

(please read the eligibility criteria and check whether any further information is required to be submitted with this form?)

My professional accrediting body is(Required)

Membership/registration number(Required)

Do you meet the EMDR Ukraine Association Criteria including 100 hours for your own therapy and 2 years experience of providing psychotherapy

(references to support this are required – Please see emdr Ukraine criteria)

Your place is only confirmed once your eligibility has been confirmed.

Please indicate you have read our terms and conditions with particular attention to our cancellation policy .

Yes

Please indicate you agree to the terms and conditions

Yes

Please email covering reference (if required).

Yes