Deborah Robertson’sBREASTFEEDING SPECIALIST COURSE

NEC BIRMINGHAM

BOOKING FORM: January - December 2015

1)CHOOSEthe course or just certain day(s) and tick ONE of these three to indicate your choice:

 / Breastfeeding Specialist Course
inone year (dates below).
PRIORITY given to these folk. / This course is approved by the Lactation Education Accreditation and Approval Review Committee (LEAARC).
This course requires that you complete all 12 study days & homeworks.
 / Breastfeeding Specialist Course completing course begun anotheryear / If you missed particular day(s) in a previous course, you may complete the course by booking to catch up those days in this year.
 / Individual Study Days / One or more study days may be booked by those not booking the course or not intending to do the monthly homeworks.

2)RESERVE THE DAYS you wish to attend(tick):

 / Monday Jan 5th 2015 / #10 Exploring the Idea of Becoming a Lactation Consultant
 / Monday Feb 2nd2015 / #1 Troubleshooting Positioning and Attachment Problems
 / Monday Mar 2nd2015 / #2 Parenting Philosophies & Relationships Impacting Breastfeeding
 / Monday Apr 13th2015 / #3 Challenges of Breastfeeding Beyond the Newborn Period
 / Monday May 11th2015 / #4 Skills for Counselling the Breastfeeding Mother
 / Monday June 15th2015 / #5 Breastfeeding in Difficult Circumstances
 / Monday July 13th2015 / #7 Facilitating Fantastic Breastfeeding Groups and Classes
 / Monday Aug 10th2015 / #8 Ethical Issues in Lactation
 / Monday Sept 14th2015 / #9 Breastfeeding Peer Support: Realising Potential & Avoiding Pitfalls
 / Monday Oct 12th2015 / #11 Breastfeeding Clinics and Consultations
 / Monday Nov 9th2015 / #12 Breastfeeding and Food
 / Monday Dec 14th2015 / #6 Mock Lactation Consultant Exam and Revision Strategies

3)SELECT PAYMENT:tick ONE

Payment type / * Breastfeeding Specialist Course / Individual study days
Invoice to trust/ hospital/ business /  £1155 /  £105 per day
Cheque or cash at time of booking /  £935 /  £85 per day
Unwaged Bf Counsellors / students /  £715 /  £65 per day

* Price of Breastfeeding Specialist Course reflects 12 study days for the price of 11 when paid in full at time of booking.

PAY-AS-YOU-GO is available if payment for the first day accompanies this form and you always remain one study day in credit.

CANCELLATIONS can be made up to two weeks beforehand to receive a refund less 20% admin fee. A student may send a substitute in their place without any extra cost. In the unlikely event that we might cancel a particular day, we will give a full refund to all who have booked and reschedule the day to give students another opportunity to attend that part of the course.

MONEY BACK GUARANTEE: Full refund, no quibble, if not entirely satisfied.

EITHER  I enclose a cheque, payable to Deborah Robertson, to the value of £………………….….……..

OR(tick)  Please send an invoice to (NAME and EXACT ADDRESS, please.) …....…...... ….………..…

…………………………….………………………………...... ……………………………...... ……………………

4)ENTER YOUR DETAILS:

NAME …………………………………………………………………...... ……………… POSITION HELD …..…………………………………………......

ADDRESS ………………………………………………...... …………………………………………………………………………………………………......

PHONE Work: ………………………………………...... ………… Home (required) ………………...... ……...…………………………...... ………

EMAIL (print VERY clearly) ………………………………………………………...... ……………………...... ………..

Where did you find out about this Course / Study Days? ….……….…………………………………………………………………..

5)CANDIDATES FOR THE IBLCE EXAM

Will you be a candidate for the Lactation Consultant Exam? ………...... … What year? …….………...... ……..

Are you already an IBCLC? ………………………………………….. Year of Certification (original)? …………………………………………..…

6)RETURN THIS WHOLE FORMto Deborah Robertson, 34 Rochester Avenue, Rochester, Kent, ME1 2DW

ENQUIRIES: Email: Phone: 01634 814275