Course Application Form
Your Name:
Organisation Name:

(if course funded by them)

Address:

Postcode:
State:
Country:
Phone (Home):

Phone (Work):

Email Address:

Occupation:
Professional Qualifications:
Course you are appliying for:
(tick appropriate box)

Summer School (Core Course + Adults & Grief)
Winter School (Core Course + Adults & Grief)
Core Course - Bereavement Counselling
Working With Bereaved/Dying Adults
Working With Bereaved Children
Post Graduate Diploma in Bereavement Counselling
Distance Learning Program - Bereavement Counselling Diploma
Post-Graduate Diploma - Counselling Bereaved Children
General Couselling Course
Clinical Supervision
Bereavement Support Workers Certificate

Date of course you wish to attend:
Previous training in this area (include those completed at the B.C. Centre):
Previous work experience in this area where relevant:
Aims in undertaking this course:
Please indicate if you are going to pay for this course on-line:
Yes, I will be paying for this course on-line. Important Please read the following Course Enrolment Information,  for conditions that apply for registrations, cancellations, transfers and refunds. Course Enrolment Information
  • All courses are from 9.30am to 4.30pm - venue to be advised.
  • Registrations and transfers cannot be reserved by phone.
  • Applications are not confirmed unless accompanied by a deposit of $330.00.
  • The balance of fees to be paid four (4) weeks in advance of the commencement of the course. If the course becomes full you may be required to pay the balance immediately to confirm your place.
  • Time does not permit us to send reminder notices for the course in which you have enrolled.
  • NO REFUNDS or TRANSFERS will be made later than 4 weeks before the commencement of any course.
  • Applications for TRANSFER to another course will only be accepted in writing. (One transfer only applies and must be undertaken within 12 months of the commencement of the original course. No refunds on transfers.)
  • CANCELLATION fee of $50.00 will be charged on cancellations made up to four weeks prior to course commencement. No refunds are made when cancellation occurs within four weeks of course commencement.
  • We reserve the right to change the above conditions, dates and fees.
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