Facilitator Scheme Enrolment Form

Personal Details

Name*:
Organisation:
Address*:
Invoice address (if different):
Tel:*:
Email*:

Qualifying Conditions

I believe I am qualified for enrolment under one or more of the following (please tick one or more and provide details where required)

1.

I am currently employed or have recent experience in a role where consultation and public engagement is relevant.

Tick if appropriate:
Provide details:

2.

I am a current holder of the Institute's Certificate of Professional Development (CPD).

Tick if appropriate:

3.

I have a qualification in Facilitating, Public Engagement or another relevant discipline.

Tick if appropriate:
Provide details:

4.

I have attended a professional training course on facilitation.

Tick if appropriate:
Provide details:

Applicant Agreement

If accepted for enrolment I agree to pay the initial enrolment fee or the all-inclusive fee

Initial Enrolment fee of 125 pounds plus vat:
OR, all-inclusive fee of 495 pounds plus vat:
I have read and accept the terms and conditions*: