2018 Registration Form Alcohol & other Drugs Training
Training Coordinator : Christina Murray-McEleney, Donegal ETB .
M: 0879369312
T:0749161508
E: christinamceleney@donegaletb.ie

In order to communicate with you about the course you have registered for, we will need your email address & telephone or mobile number.
At the bottom of the form you can decide whether or not you wish to receive any further information about future education & training opportunities.

Email address *
NAME OF COURSE YOU ARE INTERESTED IN? *
Your answer
DATE(S) OF COURSE *
Your answer
Your Name *
Your answer
YOUR OCCUPATION: This question is optional, the purpose of the question is to gain an insight into the range of disciplines that participate in Alcohol & other Drugs Training & Education in order to ensure the training content has relevance.
Your answer
TELEPHONE / MOBILE NUMBER : your number is needed so that you can be contacted about the course you have registered for. *
Your answer
Have you previously completed any alcohol & other drugs training ? (This information helps the trainer pitch the training level)
Your answer
What do you hope to learn from this training?
Your answer
CONSENT *
Required
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