Complete this application form when applying for the berevement counselling programme, and forward on with the full fee



Name
:             
                                           
Age:                   Gender
:



Tel:         
                                                       

E-mail:                



Address
:               
                      



 


Please state
any previous
relevant training
courses attended
, if any:



 



 

 



 



 



State any
relevant previous and present work experience, or qualifications, if any?



 



 



 



 



 




What are your reasons for wanting to embark on th
is
course at this particular time in
your life?



 



 



 

 

 



Any other comments

 

 

 

 

 

Return to: Norman Warden,
GCS, Cnocan an Bhodaigh, Furbo, Co.
Galway. Email as attachment.