DFAC_Professionals Container Registration

Dying for a CuppaⓇ - The Professionals Container

Coaching, Connection and Community - Registration Form
Name

First NameLast Name
Pronouns
Contact Number
Please enter a valid phone number.Format: 00000 000000.
Would you like to be added to the private Whatsapp group?
E-mail
example@example.com
Address - only needed to send your special introductory and graduation gifts

Street Address

Street Address Line 2

TownCounty

Postal / Zip Code
Current role/company name
Tell me a little bit about yourself...
In brief, what are your personal and professional goals going forward?
What do you hope to gain/learn/achieve specifically from working with me in this coaching container environment?
Please note: By registering for the 'Dying for a Cuppa Ⓡ – The Professionals Container, you acknowledge that this is a safe, confidential, and professional learning space. Participation is voluntary and your responsibility. Attendance at every session is encouraged and the responsibility for applying the learning and insights gained rests with you.

Full details of participant responsibilities, policies, and all the programme information is available for reference below.

By signing you are agreeing to all information in that document.

Once your form has been received, you will be sent a direct payment link by email.

Payment can be made via bank tranfer or card payment.
Please read before you sign.
I have read and understood the Policies and Programme document
Signature
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Dying for a CuppaⓇ - The Professionals Container