Conversations for Connection - Workshops for Couples
Couples Workshop
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Registration page
BLOG - How to get back to one another
Conversations
for Connection
Registration Form
Contact details
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Indicates required field
Name
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First
Last
Mobile no.
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Name
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First
Last
Mobile no.
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Email address:
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Email address:
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Address
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Address
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Select drop down menu for workshop location & date
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Tauranga November 01-02-03 2019
Tauranga March 7th-8th 2020
Tauranga July 4th-5th 2020
Tauranga October 10th-11th 2020
Home phone no.
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Payment Options - please select one
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Early bird couple $550.00 - payment within 48 hrs of confirmation email
Earlybird Individual $275.00 - payment within 48 hrs of confirmation email
OR: Full fee Couple $650.00 - pay at least two weeks before workshop
Full fee Individual $325.00 - pay at least two weeks before workshop
OR: Payment plan - please discuss with us - full payment due at least two week's prior to workshop, or by commencement of workshop - non-refundable
Payment method
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Bank Deposit 01-0170-0181836-00 Options Counselling
Payment Plan - full payment due two weeks before workshop - please discuss with us
Please note: Refunds will be available up to 1 month prior to the workshop commencing. After this time you can transfer to an alternative workshop date. Cancellations of 50% within 1 month of workshop date. An administration fee of $50 will apply for any cancellations or transfers.
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How did you find out about this workshop?
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What are your goals in attending the workshop?
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Are there any concerns for you or your partner that you think we should know about in relation to domestic violence, mental health issues, alcohol or drug use
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Yes
No
Anything else?
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Are you currently working with a couples therapist?
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Yes
No
Please tell us if you would like to receive information regarding future workshops / events
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Yes
No
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