New: Integrated Action Course

Terms & Conditions

We never share your information. However, if you would like to subscribe to our newsletter to receive information about our forthcoming courses and events, please tick this box.

I confirm by ticking this box that I have read the course description and relevant information sheets and understand and agree to the Terms & Conditions of the Mindfulness Network.

About you

Title:
Forename:
Surname:
Address:
Town/City:
County:
Postcode:
Country:
Phone:
Email:

Please provide emergency contact details below:
Name of contact:
Relationship to you:
Phone number:

I am a Mindfulness Network Associate:

Where did you find out about this event?

Please provide further information:

Your Mindfulness experience and practice

Please give details of any previous mindfulness courses, and/or training you have attended.

Course fees

Please select the fee that you're paying

Is your employer or a company/organisation paying your fee?

Recognising the administrative overhead of dealing with employers, we will be adding a £50 surcharge if the employer is paying directly; where possible we would recommend that applicants pay themselves and reclaim on expenses to avoid the charge. Responsibility for payment remains with the attendee. Please note: If your employer is paying, a deposit option will not be available, and the full amount will be invoiced.

Please tick to confirm you have read the above information

Please provide further details of where to send your invoice: Organisation name:

Address for invoice to be sent:

Postcode:

Contact name:

Contact email address:

Contact phone number:

Do you have a purchase order number - if you are working within the NHS, this is usually necessary:

Your physical and mental health

It is helpful for us to have some information about you so that we can best meet your needs at the event. Please provide information, if possible, to the following questions:

Do you have any physical illness or other limitation that may make hearing, sitting, or standing difficult?

Please provide further information:

Do you have any mental or physical health issues or concerns, or have you experienced recent challenging life events that would be useful for the trainers to know about?

Please provide further information:

Once your application form has been received we will be in contact with you to complete your booking for this event.

Other information

Please provide any other information you would like to pass onto the admin team or teachers in connection with this application.

The Mindfulness Network

Application Form

New: Integrated Action Course

GET TO KNOW US

T&Cs

READ OUR BLOG