Essentials ofPsychosynthesis
1) Course Details
Date of Course:2) Personal Details
First Name:Surname: / Title:
Address:
Post Code:«postcode»
Home Tel: / Work Tel:
Mobile: / Date of Birth:
Email:
Please note that the Trust circulates information to enrolled students by email wherever possible.
Have you attended an Open Evening?
3) Further Information
Why do you want training in Psychosynthesis?What is your current professional background and occupation?
What experience have you had in the field of psychology? (Individual or Group sessions, Courses, Workshops, Education etc.)
Have you ever undergone psychiatric treatment or received medication for psychological disturbances? If YES how long ago and please give a brief description of the circumstances leading to treatment.
Are you presently undergoing psychiatric treatment or receiving medication for psychological disturbances? If YES, please enclose written permission from your doctor for you to attend this course.
How satisfied are you with your personal life?
What are the main inner obstacles as you see then to your self-realisation?
Describe briefly the most significant turning point, the periods of re-orientation in your life.
What experience have you had in Psychosynthesis?
Who are people, past and present, that you value most?
Is it your intention to apply for the Professional Training programme?
What reaction did you have to these questions?
How did you hear about our training?
Word of mouthInternet search
Advert (please specify where below)Other (please specifiy below)
Additional Needs
As an inclusive organisation, we want to provide the best support possible to a wide range of applicants, including those with additional needs. Additional needs include any disabilities or supplementary educational needs that you may have such as physical or sensory impairments; mental health difficulties including depression; specific learning difficulties like dyslexia and aspergers; and health conditions such as HIV, epilepsy, arthritis and cancer.
The information that you provide here will not be used to assess your academic suitability for the programme but to ensure that, if you are made an offer to study, we are aware that you may need extra support.
Do you have any disabilities or additional educational needs?
No disability Learning difficultyBlind/partially sighted
Deaf/partial hearing Wheelchair user /
Mobility impairmentMental health
Autistic Spectrum
Condition Other disability
Finance Details
In order to secure a place on a course, you must supply payment of £350 together with your application.
You can make payment online via PayPal by clicking the ‘Buy Now’ button on our website. Alternatively, you can make payment by cheque made payable to Psychosynthesis Trust or credit/debit card. Please refer to our website for the latest prices and tick below:
I have submitted payment online via PayPal
I have enclosed a cheque payment of £
Cheques should be made payable to Psychosynthesis Trust.
I would like a member of staff to call me to take payment
Cancellation Policy:
If you are accepted on the course and you cancel 15 days before the first day of the course, you will be entitled to a 75% refund. If you cancel 14 days or less before the first day of the course, you will not be entitled to any refund.
Name:
Signature:Date:
RETURN APPLICATIONS & PAYMENT TO: Psychosynthesis Trust, 92-94Tooley Street, London Bridge, London, SE1 2TH.
Psychosynthesis Trust registered charity no. 1077365company limited by guarantee in England reg. no. 3838253. Registered office 92-94 Tooley Street, London Bridge, London, SE1 2TH
tel 020 7403 2100
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