REGISTRATION

Name:  ...................................................... Tel:  .....................................

Address:  .................................................................................................

                 ................................................................................................

E-mail: ....................................................................................................

[  ] I would like to book a place for the following Introductory Workshop(s)

................................................................................................................

[  ]  A deposit of £60 is enclosed, or

[  ] A cheque for the full amount is enclosed

[  ] I would like to book a place for the following Workshop(s)/Retreat with Linda

...................................................................................................................

[  ] A deposit of ...............  is enclosed, or

[  ] A cheque for the full amount is enclosed

As places on all workshops are limited, early booking is advised

NB:

• Bookings are only secured once a deposit or the full fee has been received, along with this form
• Deposits are non-refundable
• The balance should be paid by one month before the start of a course
• Places cancelled less than one month before the start of a course must be paid for in

 full, unless the place can be taken by someone from our waiting list. In this case

there will be only a small administrative charge

• Payment should be by cheque or bank transfer (please enquire for details)

Please make cheques payable to ‘IBMT-UK’, and send to:

                       IBMT

                       Godelieve Tempelman

                       1 Henry Blogg Road

                       Cromer

                       Norfolk

                       NR27 0JG

                       _____________________________________

Continued/PTO

We would like to know a little about you

Please respond briefly to the following if you have not worked with us before:

Please give a little information about your training and professional       

background.

What is your particular interest in this course, and how do you hope to  

use what you learn?

What experience do you have of personal therapy, if any?

Is there anything else you would like us to know about, such as an illness or injury which

 might affect or be affected by your participation in a course?