Introduction to Clinical Hypnosis Day

Application Form

Please enter your information in the form below to apply for the Introduction to Clinical Hypnosis Day on the 15th November 2025.

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Name
First Last
Address*
Street Address Address Line 2 Suburb State Postcode
Mobile*
Email*
Profession*
How did you hear about the workshop?*
Example: Website, Word of mouth, Flyer or Advertisement
Dietary Requirements
- Vegetarian
- Gluten Free
For other dietary requirements you are welcome to bring your own food. Our food is prepared in a commercial kitchen, so we cannot guarantee there has been no exposure to allergens.
Payment
Payment Type*
- Introduction to Clinical Hypnosis Day only – $110.00
- Course Student – Free
Complimentary for next year’s Clinical Hypnosis Course participants who have registered and paid a deposit before 8 November.
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Payment Method
- Invoice with 'Pay by direct deposit'
- Invoice with 'Pay by PayNow' (credit card or PayPal)
Personal information will remain confidential & not shared with any other entity.