11th Biennial Conference
for those new to or experienced in Exploratory Goal-Corrected Psychotherapy (EGCP)
Wednesday, 4th October - Saturday, 7th October 2023
The Conference is non-residential
St Bede's Pastoral Centre
21-23 Blossom Street, York, England YO24 1AQ
Conference Fee: £385
To secure a place, a deposit of £85.00 is required on acceptance. Bank details will be issued once an application has been approved
REGISTRATION FORM
Attendance at the Conference is subject to an approved application
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
Contact telephone number
Please include international dialling code. Mobile numbers are preferred and it would be helpful if you have access to WhatsApp
Profession or student status
Professional qualifications attained (if any)
If qualified, length of time qualified
Membership of professional organisation (if any)
Emergency contact name and contact number
Include international dialling code. Mobile numbers are preferred
Current work situation, roles and responsibilities
Number of experiential courses attended with Una McCluskey, or with a caregiver trained in the McCluskey Model
Please Select
None
One
Two
Three
More than three
Number of conferences attended which have been facilitated by Una McCluskey
Please Select
None
One
Two or more
Subject to completing the required number of experiential courses/conferences, are you interested in the two-year training programme in the McCluskey Model?
Please Select
Yes
No
Maybe
Already Trained
The minimum requirement is attendance at two experiential courses (either face-to-face or on Zoom) and one conference.
Are you interested in further experiential courses, run by Una McCluskey or somebody trained in the McCluskey Model. This may require us to share your email address with trained members
Please Select
Yes - with Una McCluskey
Yes - with someone trained
Yes - with either
No
If you are new to the Conference, how did you hear about it and what do you hope to learn from your experience?
The experiential aspect of the Conference can be stressful. Do you have personal and/or professional support in your life at the moment?
Please Select
Yes
No
In line with the requirements of GDPR, do you consent to us holding your details on our database so that we can inform you of future courses, workshops and conferences?
Please Select
Yes
No
Submit
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