SASH Course Application

Please enter your information in the form below to apply for the SASH Clinical Hypnosis Course 2023.

Limited numbers available….

SASH Course Application & Membership Form

PERSONAL DETAILS
Title*
Name*
First Last
Address*
Street Suburb State Postcode
Mobile Number*
Email Address*
Profession/s*
REGISTRATION DETAILS
Current AHPRA or Other Professional Registration*
- AHPRA
- Other Professional Registration
Name of the other professional registration
Registration Number/s*
State/s of Registration
HIGHEST ACADEMIC QUALIFICATION/S
Highest Academic Qualifications relating to profession in which you will be practising hypnosis.
Name of Institution/s:*
Degree/s granted:*
Date/s achieved:
Summary of Post-Graduate Professional Experience, Certificates & Diploma Training*
Summary of previous training qualifications, experience or publications in Hypnosis
Your Goals*
Please provide us with details of your primary goals for learning how hypnosis can be utilised in you practice
Are there any dates that you may be unable to attend on the course

(This could impact on course completion)
COVID Vaccination Certificate*
Max. file size: 96 MB.
Please upload your up to date COVID Vaccination Certificate, thank you.
Dietary Requirements
- Vegetarian
- Gluten Free
For other dietary requirements you are welcome to bring your own food and use the kitchen facilities. Our food is prepared in a commercial kitchen and transported to us, so we cannot guarantee there has been no exposure to allergens.
How did you hear about the SASH Course?*
Payment
Payment Type*
- Full Payment-Invoice with 'Pay by direct deposit'
- Deposit Payment-Invoice with 'Pay by direct deposit'
- Expression of Interest (no payment)
Course Fee includes: All course & graduation fees, 12mths Trainee membership & then another 6mths full membership
Consent*
I hereby undertake and agree that if accepted for the course & membership I will abide by the Constitution and the Code of Ethics of the South Australian Society of Hypnosis Incorporated
Personal information will remain confidential & not shared with any other entity.
Comments
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South Australian Society of Hypnosis - Hypnosis Leaders in South Australia

SASH Course Application & Membership Form

PERSONAL DETAILS

REGISTRATION DETAILS

HIGHEST ACADEMIC QUALIFICATION/S

Payment

AGM – 30 September 2022

SASH Course 2023

Registrations now open for Postgraduate Training in Clinical Hypnosis

Practitioners

Search our directory of Hypnosis practitioners in South Australia