Debriefing Seminar Registration Form

Family Name *
First Name *
Sex *MaleFemale
Nationality
Do you need a visa for France? *YesNo
Full Postal Address
Telephone
Fax
Email *
Organization for which you work *
Title/Role
I wish to be lodged at Le Rucher *YesNo
If you are on a special diet or have any special food requirements, please explain
What is your involvement with member care? *
How do you expect to use this training in the future? *
Please describe any previous training or experience you have had in pastoral care or debriefing *
What expectations does you organization have on how you will use this training? *