Training Course Registration Form
ADMISSION REQUIREMENTS
The courses are restricted to those 18 years & older.
Engaging in this form of learning may be stressful, therefore, the course is not recommended for those experiencing severe stress.
Should you be in therapy you need written permission from your therapist and hand it in with your registration.
Attendance of all sessions is an important requirement. If more than one session is missed no certificate will be issued.
Full payment is required after registration to be admitted to the course.
Sign in to Google to save your progress. Learn more
Email *
Email *
Full Name *
Contact Number *
Emergency Name and Contact Number *
Email Address *
Age *
Gender
Clear selection
Residential Suburb/Area
Marital Status
Clear selection
Occupation
Student Number
*Members of NMU Student Psychology Society are entitled to a discount
How did you hear about the course?
Clear selection
Are you experiencing severe stress or are you currently receiving counselling ? *
Please note engaging in this form of learning may be stressful, therefore, the course is not recommended for those experiencing severe stress.
Do you have a health condition that could impact your safety? *
If YES, please specify. (e.g. heart condition, diabetes, severe allergies, severe phobias, asthma, etc.)
2024 Course Dates
Trauma Support Course | 2 session course | R1130
Term 1: 7 - 8Feb 
Term 2: 28 - 29 May

Personal Growth Course | 8 session course | R1450
Term 1: 22 Feb - 11 April  2024(1 session per week)
Term 2: 11 July - 29 Aug 2024 (1 session per week)

Anger Management Workshop | 1 session course | R700
Term 1: 27 March 2024
Term 2: 02 July 2024
 
Understanding Addiction Workshop | 1 session course | R500
Term 1: 04 May 2024
Term 2: 07 Sept 2024
 
Basic Counselling Skills | 8 session course | R1450
Term 1: 9 May - 27 June 2024 (1 session per week)
Term 2: 14 Sept - 2 Nov 2024 (1 session per week)

Different Approaches to Counselling | 4 session course | R1150
Term 1: 12 July - 2 Aug 2024 (1 session per week)
Term 2: TBA

Narcissism Workshop | 1 session course | R500
31 Aug 2024


Please select the courses you wish to register for.
For course dates, please refer to section  above.
Please note that full payment is required upon registration to be admitted into the course.
Second Term
Trauma Support Course
Personal Growth Course
Basic Counselling Skills Course
Different Approaches to Counselling Course
Anger Management Workshop
Narcissism Workshop
Understanding Addiction Workshop
Course Fees*
Trauma  Support Course - R1 130 
Personal Growth Course - R1450  
Basic Counselling Skills Course - R1450  
Different Approaches to Counselling Course - R1250  
Anger Management Workshop - R700  
Narcissism Workshop - R500
Understanding Addiction - R500

NMU Psychology Student Discounted Rates:
Trauma  Support Course - R1 117
Personal Growth Course - R
Basic Counselling Skills Course - 
Different Approaches to Counselling Course - 
Anger Management Workshop - R630
Narcissism Workshop - R450
Understanding Addiction Workshop - R450

*FULL PAYMENT IS REQUIRED TO BE ADMITTED INTO THE COURSE.
Payment Details
Banking details
Account Name: Revive - Empowering Emotional Change
Nedbank, Greenacres
Account number: 1005876711
Account type: Cheque
Branch code: 121617
Reference: "Course code and Surname"
PLEASE SEND PROOF OF PAYMENT TO: aviwe@revive.org.za | director@revive.org.za




Course Codes
Trauma  Support Course - TSC
Personal Growth Course - PGC
Basic Counselling Skills Course - BCS
Different Approaches to Counselling Course - DATC
Anger Management Workshop - AMW
Narcissism Workshop - NW
Understanding Addiction Workshop - UAW
Terms & Conditions
1. Payment in full is required upon registration to be admitted into the course.
2. Participants should inform the course coordinator at the time of registration if they are experiencing severe stress or are receiving any medical or psychological treatment at the time.
3. While every care is taken to ensure that this programme is correct at the time of publication, REVIVE reserves the right change the programme without notice and/or to postpone or cancel the event. In case of postponement or cancellation full refunds will be provided.                            
4. REVIVE is committed to quality training and people development. The number of participants to the course limited in order to ensure maximum participation and personal attention.                  
5. REVIVE reserves the right to refuse admission to or participation of its courses at its sole discretion. The courses are restricted to those 18 years & older.
6. Training will be conducted ONLINE on MS Teams.
7. Should you be in therapy you need written permission from your therapist and hand it in with your registration.
8. Attendance of all sessions is an important requirement. If more than one session is missed no certificate will be issued.  
9. In the case of cancellation before the start of the course date, a 50% cancellation fee will be charged. If you cancel after the course has commenced, a 100% cancellation fee will be charged. 
10. Should you have any questions or concerns, please contact us at info@revive.org.za
I have read and agreed to the above terms *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report