Workshops

Clinics at Petrie & Eight Mile Plains - Brisbane.

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Options Communication Therapy and Training Centre Pty., Ltd. www.optionsctc.com.au email: optionsctc.com.au tel: 3205 5522 mobile: 0410 448 523

Application Form for Workshops

PLEASE DON’T LEAVE IT UNTIL THE LAST MINUTE TO GET YOUR APPLICATION TO US.THE CLOSING DATE FOR WORKSHOPS IS TEN DAYS PRIOR TO PRESENTATION DATE.

Tick the workshops you wish to attend	Venue	Date Time	Costs
[ ] Facilitated Communication Training: Basic	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection.	Saturday February 6th	$150 (includes manual and am/pm tea)
[ ] Facilitated Communication Training: Basic	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection.	Saturday Monday 8th March	$150 (includes manual and am/pm tea)
[ ] Introduction to Augmentative and Alternative Communication (AAC)	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection	Monday April 12th	$150 (includes manual and am/pm tea)
[ ] Write Me A Story.	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection	Monday April 19th	$120 (includes am/pm tea)
[ ] Facilitated Communication Training: Basic	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection.	Monday May 10th	$150 (includes manual and am/pm tea)
[ ] Teach Me To Talk.	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection	Saturday May 24	$150 (includes manual and am/pm tea)
[ ] Facilitated Communication Training - ADVANCED	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection	June 28/29.30	$600 per person for the 3 day block course.
[ ] Facilitated Communication Training - ADVANCED	Meeting Room 1. Pathways at North Lakes. Anzac Av/Bruce Highway Intersection	July 1 August 2 Sept 6	$600 per person for the 3 day course

Please print

Name:	Participants mobile.	Amount being paid.

Payment method : Circle Cheque/Cash/ Credit Card	Credit Card Number	Expiry Date
Mastercard or Visa	__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __

Please note that a $2 payment processing fee will be charged to credit card payments to reflect

bank fees and charges.

Signed: ________________________________Date:_______________________________

How to Send Your Application: Email on optionsctc@iprimus.com.au or post the registration with your

payment to: - Options, P.O. Box 568, Kallangur Qld. 4503

Office use only

Received _________________________________ Confirmation Sent______________________________________