EOI/ WAITLIST Circle of Security

Circle of Security - Classroom Approach

Waitlist form / Expression of Interest form
2025 / 2026

Last course October 2025
Name

First NameLast Name
Position / Role
Company/ Organisation Name
Email
example@example.com
Will this course be covered by School Readiness Funding ?
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
List the full names of other participants who will also be doing the course
Please provide some details about why you would like to do the Circle of Security Classroom Approach program
Which course would you like to sign up to?

Full Certificate $450 - 8 weeks (this model includes weekly coaching and therapeutic benefit)Abbreviated Certificate $380 - 4 weeks (This model is more content-heavy but still allows for reflection)Introduction Certificate (Workshop) - 1 session
Please select what term you are hoping to participate in the course

Term 1Term 2Term 3Term 4
Please select group (Select all that are suitable) you will be notified which groups you have been offered a position in and can confirm through payment once offers are announced

I would like a private course for myself or my team at a tailored timeMonday MorningMonday MiddayMonday AfternoonTuesday MorningTuesday MiddayTuesday AfternoonWednesday MorningWednesday MiddayWednesday AfternoonThursday MorningThursday MiddayThursday AfternoonOther
Thank you for your interest in completing the Circle of Security Classroom Approach. Elise Disher will be in touch shortly to provide further details about your enrolment
I understand that once Payment is made it is non-refundable. I acknowledge that Live Attendance to the online classes is required as the sessions are not recorded. I have read the description of the Circle of Security Program and ensured it is relevant to my professional learning before committing to participate in the program. (signing this form acknowledges you understand the above, it does NOT confirm your enrolment or obligate you to sign up officially to the course)

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Circle of Security - Classroom Approach

2025 / 2026