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Registration form
Full Name
*
First name
Last Name
Email
*
Phone Number
*
-
Area Code
Phone
Which of the following best describes you?
*
Student planning to pursue a career in mental health
Professional involved in training mental health practitioners
Both
Other
Organisation / Educational institution
*
Programme of study
Current year of study
Please Select
Year 1
Year 2
Year 3
Year 4
Year 5 or above
Are you currently a UNIC student?
Yes
No
Student ID
Other participant category — please specify
Professional discipline
Psychology
Psychiatry
Counselling or Psychotherapy
Social Work
Nursing
Other
How are you involved in training mental health practitioners?
Teaching
Clinical supervision
Training or workshop delivery
Programme coordination
Other
Future Communications Consent
I agree to receive communications about future UNIC events and updates.
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