Registration Form
Counselling & Psychotherapy Course
Name of the Participant *
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Certificate course opted *
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Highest Education Qualification *
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Specialisation
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Counselling Experience
Years of Experience
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Are you working currently?
If yes, what is your designation?
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Where do you work?
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Phone Number *
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Email ID
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Have you paid your course fee?
Details of the bank transfer (Bank Name & Branch)
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Bank transaction number
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DD/ Cheque number
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Amount Paid
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