Enrolment Application – Overcoming Problems Course

Applications for enrolment to Overcoming Problems 1 can be made for several weeks after the program begins. Several catch up classes will be taught for those late starters. After the cut off date, it is too difficult for most people to catch up. The course cut off date for new applications in Townsville is Sept 19th 2018.

IMPORTANT: Please fill out all the questions as best you can. The fields with an ( * ) are mandatory.  

Privacy

All information is strictly confidential and strictly adhering to the AITHP & TBHP Privacy Policy. AITHP and TBHP are committed to respecting your privacy. You may visit our website and browse without giving us any personal information.

Your Details

Please fill in the requested information.

Have you enrolled in this program before? If yes, when? *

Your Name *

Landline number

Mobile number

Your Email *

Suburb (where you live) *

Occupation *

If retired, previous occupation(s) *

Educational background (areas of study)

Please fill in the requested information.

Degree(s)? *

Diploma(s)? *

Certificate(s)? *

Post-graduate / Professional development *

Are you currently studying? If yes, what are you studying? *

How did you find out about the program?

Please tick all that apply and fill in the requested information.

Internet (which Web site/search engine) *

Friend referral (name) *

Flyer (location) *

Poster (location) *

Newspaper (which one) *

Other (please indicate) *

Other questions

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Why did you decide to enrol in the program? *

Do you have any illness or injury that restricts your mobility doing exercises and meditating? *

If you answered yes, please specify (optional, please type ‘not answering’ if you prefer not to answer).

Are you interested in: *
the Psychology of Buddhism?Buddhism as a Religion?Buddhist Philosophy?Wanting to change for the better?

What is the nature of your problem? (tick the boxes that are applicable to you) *
AngerStressAnxietyEating DisorderAddiction (what kind?)GriefRelationshipsIllness or disabilityFear or phobiasJealousyIsolationGetting along with othersLife event e.g. loss of job/career; accidentTrauma

TERMS AND CONDITIONS

Tick the box to accept Terms & Conditions *

I understand the organisation is run entirely by volunteers in their spare time. Therefore, some emails may not be answered or calls not returned due to time constraints. There are certain criteria for acceptance of applicants who are minors. I understand that all course material (be it written, verbal or DVD) is protected by copyright and I will not record or use any course material in another setting, situation or format. Enrolment will not automatically guarantee a place in the course. There are sexual harassment and privacy policies in place at AITHP & TBHP and I have completed this form truthfully and to the best of my knowledge and understanding.

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