AAI_INSTITUTE Booking Form - The John Bowlby Centre

DECLARATION OF INTEREST TO PARTICIPATE IN AN AAI-INSTITUTE AT THE BOWLBY CENTRE, LONDON, NOVEMBER 2019

We would like to get an idea of how you intend to use the AAI clinically and/or in research. Our experience from other institutes tell us that it is of great value if more than one person from the same unit are trained AAI coders. Having AAI colleagues entail the possibility to cooperate on coding difficult cases, and, not the least, to provide support and encouragement. Indicate if somebody else at your unit/university is interested in participating in this AAI-institute or is already a trained AAI coder.

I am interested in participating in the AAI-institute at the Bowlby Centre, London, November 2019.

Name *

Profession

Workplace

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Email *

Other interested or trained person with whom I can collaborate:

Brief description of your clinical work/research project and how you plan to use the AAI:

How did you hear about the course?

Email
Website
Personal Contact
Other

I wish to pay the deposit of £385 and pay the balance upon receipt of the invoice, which will be sent when accepted on the course.

Deposit £385

Non-refundable deposit payable upon booking, no later than 1st August 2019.
Balance due on acceptance of course, no later than 21 October 2019.
Applicants not accepted will be refunded their deposit monies.

Total Amount

£0.00

Any Special requirements?

Booking Terms and conditions

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Please contact Carol Tobin admin@thebowlbycentre.org.uk for any queries