booking form

Medical
This course may not be suitable for people with long-term or severe mental illness, or who have regular experience of psychotic or severe anxiety episodes, or who are dependent on illicit drugs. If you are on any prescription drugs please let me know. It is essential that you discuss any illness of this kind, or treatment you have had, with me before enrolling. This may not exclude you from doing the course, but I'd need to know about it so that we can be sure the course is right for you.

I need to know about relevant physical medical conditions or incapacities as well, and any special requirements that these may involve. If in any doubt please phone me first so we can discuss if the course is for you.

Age
I usually set a lower age limit of 21 years old minimum. If you are a little younger but wish to do the course, please phone me to discuss this.

Booking
Please complete the form below (if you cannot print it off, contact me and I will send you a copy) and return it to me at:

Richard Mills
Room 6, First Floor,
Oakwood House,
637 Roundhay Road,
Oakwood,
Leeds LS8 4BA

Alternatively, cut and paste the text below and email it to me.

Please send a deposit of £50 (cheques payable to Richard Mills). If you cancel your place more than six weeks before the course begins I will refund your deposit. The balance of £200 is due by 28 December 2009. If you have a problem with that we can discuss it. I will send you a receipt within a week of receiving your payment.

IMPORTANT: If you are not yet sure that the course is for you please phone me for a discussion about any questions you may have. You are also welcome to meet me in Leeds if you wish. Some people come onto my courses on personal recommendation by other co-counsellors, but if I have not been recommended to you, you may be wondering if I am the right person for you to work with. If you would like to 'meet' me on the phone please feel free to phone me for a chat about the course.

Book soon to avoid disappointment: Places are limited. Act now and make it happen!

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ENROLMENT FORM: ‘Know Yourself: The Fundamentals of Co-Counselling’
Leeds, Jan/Feb 2010, five days
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Please reserve for me a place on the above course.

NAME………………………………………………………………………………………

ADDRESS………………………………………………………………………………….

………………………………………………………………………………….

Email address…………………………………………………………………………………..

PHONE: DAYTIME……………………......…..EVENING………....……………………..MOBILE...............................

I understand that a minimum of 85% attendance is necessary in order to be considered ready to co-counsel in the Co-Counselling International (CCI) network and attend CCI events.
I have read and accept the contract below.

I am over the age of 20 years / I am under 21 years old (delete).

Signed………………………………………………….Date……………………………..

How did you hear about this course?

……………………………………………………………………………………………………

(If via a search engine, was it Yell.com? or Google? or another

one?.....................................)

Contract for ‘Know Yourself: The Fundamentals of Co-Counselling’

I (Richard Mills) undertake to offer you the following:

A well planned and organised Foundation course that will equip you to be accepted as a co-counsellor within the Co-Counselling International (CCI) network. The syllabus will include all of the co-counselling methods and styles of working within CCI.
A secure group situation in which you can learn to use co-counselling in both the client and counsellor role, for your personal growth
Useful and clear handouts to back up the training, and other relevant information
Respectful and supportive attention
Prior discussion if I have concerns about your readiness to be accredited as a co-counsellor within the CCI network
Information about co-counselling groups and events, locally, nationally and internationally
A list of co-counselling contact persons in the UK who have contact details of co-counsellors in various areas

Your accreditation (i.e. entry into CCI) at the end of the course depends on the following:

A minimum of 85% attendance on the timetabled sessions, plus at least one practice session outside of the timetabled sessions. (You will be offered assistance in arranging this as close as possible to your home location.) Any planned absence from the course must first be discussed with me.
An understanding of and basic competence in the co-counselling method, and a willingness to adhere to this method when using co-counselling within CCI
The ability to be respectful to others
The ability to keep confidentiality
The ability to hold back from expressing your own feelings, when it is your turn to give someone else attention
A respect for others’ boundaries and needs within the group
Spending three hours minimum reading the written handouts outside of the timetabled sessions, and before the final weekend.

THERE IS NO WRITTEN TEST OR WRITTEN WORK - IT IS ALL PRACTICE. All the above points are discussed within the course.