Certificate in Mindfulness and Wellbeing Registration Form

Certificate in Mindfulness & Wellbeing For Children

Registration Form
Your Name *

First Name Last Name
E-mail *
example@example.com
Mobile Number
School / Organisation/Business Name if applicable
What State are you in? *
Please indicate which sounds most like you:

I am an educator intending to facilitate the Peaceful Kids or Peaceful Parents programs in a school or organisation as a non for profit service I am an independent practitioner and intending to purchase the Business Licence to offer the Peaceful Kids or Peaceful Parents as a business I am completing this course an independent practitioner but I will not be offering the Peaceful Kids or Peaceful Parents programs as a business I am just interested in learning more and would like to complete this Certificate program for either professional or personal growth. Other - please include comments in the additional comments box at the end of this form
What are your qualifications and/or experience? You do not need to have any qualifications to complete the Certificate however you will need to complete Module 4 (practicum module) if you don't have any formal qualifications in the field of Education, Psychology, Counselling, Social Work, Mental Health worker or similar.
Are you intending to apply for Recognition of Prior Learning (RPL) for Module 4? (i.e. you have experience and training in Education, Psychology, Counselling, Mental Health, Social Work, Youth Work or similar.

Yes I will be applying for RPL No I will need to complete Module 4 and complete my practical placement
Do you have experience working with children?

Yes I have experience No I don't have experience
What modules have you completed so far?

Module 1 - Peaceful Kids Facilitator Training Module 2 - Advanced Peaceful Kids Facilitator Training Module 3 - Peaceful Parents Facilitator Training Module 4 - Practicum I have not completed any modules yet I have enrolled in a module to start the training soon
Please note that you will need to book in and pay for each module separately to complete the Certificate. This form does not automatically enrol you in the course but is a application to begin the process. Please go to the Peaceful Kids website to book in for the Modules.
Additional Comments
Should be Empty:

Certificate in Mindfulness & Wellbeing For Children

Please note that you will need to book in and pay for each module separately to complete the Certificate. This form does not automatically enrol you in the course but is a application to begin the process. Please go to the Peaceful Kids website to book in for the Modules.