Mediation Foundation Training Application Form

Course Outline
Day 1 – Understanding Conflict/Understanding You
Day 2 – The Mediation Process
Day 3 – Communication skills in Mediation
Day 4 – Skills practice
Day 5 – Further Skills and next step
At the end of the course each trainee will complete a written portfolio to demonstrate their learning and understanding of Mediation, its processes and the skills required to be an effective Mediator.

A detailed outline of the course can be found here: COURSE OUTLINE
Please read the "Course Outline" above before proceeding to the Application Form *

Mediation Foundation Training Course

Participant Registration Form
Title: Ms./Mr./Mrs./Dr./Prof: *
Name:

First Name Last Name
Address *

Street Address

Street Address Line 2

City Country

Post Code Country
E-mail *
Mobile/Contact Number *
This course requires that you have a good standard of written and spoken English. Educational attainment to Level 2 is a requirement of the course and the subsequent course portfolio.
Please give a brief outline of your current job role and work experience paid or voluntary *
Educational qualifications *
Have you completed any previous training in any related fields Yes / No *

Yes No
If Yes, please provide details
Please state your reasons for wanting to attend the mediation skills course *
Where did you hear about the course? *
Dates of the course:

In order to ensure the course can proceed without Covid-19 related concerns and disruptions we will be delivering all our courses online until Autumn/Winter 2021

10th, 11th, 17th, 18th & 24th June 2021 (online)
Venue: The course will be delivered online via Zoom. Joining instructions will be sent prior to the start date.
Course Fees:

The cost of the course is £900.00. This cost covers all training sessions and training materials; Participants must attend all of the sessions and complete the course portfolio within 30 days of the end of the course to successfully complete the course.

There is a 10% discount for all applicants accepted and deposits paid before the 30th April 2021.
The course will proceed if a minimum of six (6) trainees enrol. If for any reason the course does not proceed, all fees will be refunded as per our terms and conditions (see below for more details).
Do you have any dietary requirements
If you have selected "Yes" above, please give details of your dietary requirements
Payment

If you are self-funding, please indicate the amount you wish to pay upon submission and acceptance onto the course, below.
I wish to pay: *

In Full Via Payment Schedule (Including deposit) By a Sponsor
Payment Shedule Terms: (via bank transfer only)

Course Fee: £900 *#

1st Payment: £250 deposit ( - * # this amount will be dependant upon whether any course discount for early payment have been offered)

2nd Payment: £250 (dependant upon deposit and course fee)

3rd Payment: £200 (dependant upon deposit and course fee)

4th Payment: £200 (dependant upon deposit and course fee)

# - If you require alternative payment arrangements please email us directly at: office@changemakerllp.co.uk.

* - All Applicants can pay up his/her full course fee at any time up to 3 weeks before the course start date

NB: Dates for the subsequent payments will depend upon the date in which the initial deposit is paid.
I wish to pay by: *

Bank Transfer – (details to be provided upon submission of the completed form). Credit or Debit Card (Payment in Full or Deposits payments only) Invoice - Payment due within 30 days of invoice. (Payment in Full Only) Online - For Payment of Deposit and Full Payments via the website (Go to Our "Course Fee" page) I am being sponsored and payment arrangements have already been made I am being partially sponsored - I will contact you directly for payment terms
If you are not self funding please supply details of the full name and address and name of the person or department to which the invoice for the course fees should be sent:
Note: Each course will have a set period in which anyone accepted onto the course will have the opportunity to get an advertised percentage % discount off the full course fee, for early payers only
* Cancellation of a course booking will be subject to the following charges

More than six weeks before course begins	Full Refund
Over 2 weeks but less than 6 weeks before course begins	75% of fee payable
Two weeks or less before course begins	No Refund

“The Service” reserves the right to alter or cancel courses. If “The Service” cancels, the course all fees will be refunded.
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Course Outline

Mediation Foundation Training Course