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PAYMENT OPTIONS
Payment (to be
eligible for student payment you mush fax or mail a
copy of your student card)
OPTION 1
Send my invoice to my organisation for the payment
amount stated above:
(Please note that place in
workshop will not be secured until payment is
received)
Name of Payer Contact:
Name of Payer:
Address:
Telephone:
Fax:
Email:
OPTION 2
Please charge my credit card for the payment amount
stated above:
Credit Card
Details
Please note that
your place in workshop will not be secured until
payment is received,
once you have
submitted your information by pressing the button
below, you will need
to
press the paypal button on the proceeding
page!
OPTION 3
Other Payment Options:
By
Cheque - Mail completed registration form and
payment to:
MENTAL HEALTH AUSTRALIA:
PO Box 250 St.Kilda VIC 3182
By Credit Card
(Bankcard, MasterCard or Visa -
please add 3% to course fee) We will need
your CARD
NUMBER, NAME, EXPIRY
DATE & SIGNATURE
• Mail details to
Unity Foundation, PO Box 250 St.Kilda
VIC 3182
• Fax details to (03)
9593 6267
• Email details to
peterk@dbtworkshops.com
• Call in details to (03)
9593 6259
Terms and
Conditions
Requests for refunds
must be made in writing. Full refund, minus a
$99 service charge, will be made for requests
postmarked 10 days prior to the beginning of the
workshop. NO REFUNDS WILL BE MADE THEREAFTER. In
unforseen circumstances, Centre for Evidence
Based Mental Health
reserves the right to cancel or postpone our
workshops & in doing so will refund registration
fees to participants.
I acknowledge the
terms regarding the terms and conditions of this
application
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