Course Registration Form – William Glasser Institute Ireland

This form is to be completed by the organiser of a course or event and, when submitted, will be sent to WGI.

Course/Event Type *

Starting Date *

Please enter the date in this format "20 JUNE 2019".

Finishing Date *

Please enter the date in this format "20 JUNE 2019".

Venue *

Full name and address of venue for course or event. E.g., "Royal Hotel, Swords, Co Dublin"

Venue Name for Certificate *

Indicate the venue name as it should appear on the certificate. If the venue is an institution that issues its own qualifications, the name should be presented in such a way as to avoid any impression that the WGI certificate is issued by them.

Instructor/Facilitator/Leader *

Full name of the WGI qualified person who will lead this course or event. If this is not yet decided enter UNKNOWN.

City/Town *

Name of the city or town where the course or event is held.

Status of the Course *

Full Name of Organiser *

Contact Phone Number of Organiser [NOT TO BE PUBLISHED] *

Email Address of Organiser [NOT TO BE PUBLISHED] *

Fee for Course

Enter the fee in Euros that is being charged to each participant.

Additional Comments [NOT TO BE PUBLISHED]

If this course is recognised for CPD points, please add a note about this here.

Data Protection *

I give permission for the above details to be stored for the purposes described below.

The data collected here will be used only for the organisation and publicising of this course.