ToP™ FACILITATIVE LEADERSHIP PROGRAM COURSE MODULE REGISTRATION FORM
This is a TAX INVOICE and RECEIPT once payment is received. GST number 92 634 019.
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Module 1+ Group Facilitation Methods
This course includes Module 1 Group Facilitation Methods and Part 1 of Module 2 – Facilitation Integration & Expansion of the ToP Facilitative Leadership Program.

This course is offered in New Zealand by Participatory Techniques Ltd (NZ) and authorised by the Institute of Cultural Affairs Australia.
Dates and Course Attendance Requirements
Wednesday April 14 - Friday April 16 2021

The course is three full days. It begins 9:00am on Wednesday, and finishes at 5:00pm on Friday.

It is intensive in nature, and includes two evening session (Day 1 and Day 2).

Full attendance is required to be awarded a Completion Certificate.
Venue
The course is being held in Whaingaroa (Raglan).

The course fee includes all meals and marae style accommodation.
Registration Per Person: $1800 + $270 GST Total $2070
Registration is confirmed once payment has been received.

If paying by invoice, please note that an invoice will be sent upon completion of this registration form.

Your registration will be held as long as payment is received by the due date provided on the invoice.

Important note: Our courses are often over-subscribed. Should we not receive your payment by the due date, your place on the course may be offered to someone from the waiting list.
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Course Confirmation
The course confirmation date is Friday 12 March 2021.

If travelling from out of Waikato, we recommend you do not book non-refundable air tickets until you have received the course confirmation notice and information pack on, or before this date.
Cancellation Policy
Should we need to cancel the course:
If for any reason we must cancel the course, your registration fee will be fully refunded.

Registration confirmation:
An invoice will be sent upon completion of this registration form.
Payment is expected by the date provided on the invoice. Registration is confirmed once payment has been received.
Important note: Our courses are often over-subscribed. Should we not receive your payment by the due date, your place on the course may be offered to someone from the waiting list.

If you choose to cancel your registration:

If you withdraw from the course before the course confirmation date of Friday 12 March 2021 your registration fee will be refunded minus a $25 administration fee.

Registration cannot be refunded if you withdraw after Friday 12 March 2021 (the course confirmation date), but you can transfer your registration to someone else.

NB: Under COVID-19 if you cannot attend as you are unwell, or alert levels prevent you leaving your region, your registration can be transferred to our next course or fully refunded.
Please tick that you have read, understood and agree to the cancellation policy *
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What Your Fee Covers
COURSE MEALS
Morning, afternoon tea, lunch, evening meal Day 1

TRAVEL
We encourage car-pooling, and will assist you to sort this should others be attending from your area.

POST-COURSE MENTORING
Post-course mentoring with a course facilitator is available for participants and is included in the fee.
Participant Details
First name *
Last name *
Iwi Affiliations
If applicable
Gender *
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Name for Certificate *
Email *
Mobile telephone number *
Office telephone number *
Organisation *
Postal or Billing Address
Number and Street or PO Box *
Suburb and City *
Postcode
Region *
Please select the region of NZ you are from from the dropdown menu. If from outside of NZ, please select 'Other.'
Do you consider that you have a disability/impairment or long-term condition? *
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If yes, please describe any special requirements you have regarding physical or learning assistance
Do you have any special dietary requirements? *
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If yes, what diet requirements do you have?
Emergency contact details *
Name and telephone number
Privacy Policy
Personal information is treated as confidential, is used only for organising training or related purposes, and will not be shared with other parties without permission from the participant unless required by law.

Participatory Techniques Ltd may from time to time provide participants with information about new courses available to them, or related matters or opportunities. Consent to this will be implied unless a participant advises in writing that they do not wish to receive this information.
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