APPLICATION FORM – Richard G. Erskine, PhD – Unconscious Relational Patterns, Cumulative Neglect, and Therapeutic Involvement

Education will be held on October 13, 14, and 15. 2023, at 6pm to 9pm (GMT/UTC + 1h).

We kindly remind you that, after you fill the form, you need to mark the field “I accept the General Terms and Conditions” and then click on the "send" button. Our coordinator will reply to you within a few days that your application has been received and accepted.

Psychiatrists, clinical psychologists, clinical social workers have the right to participate in the education, but also all other professionals (special pedagogues, andragogues, MDs, nurses…) provided that they are in the process of psychotherapeutic training.

Personal data

First and Last Name *

Country *

Phone no. *

Email *

Confirm email *

*License no. (if you have one)

Your occupation

I am

certified therapist

student

Name of the psychotherapy approach/school in which you have graduated/certified *

Name of the psychotherapy approach/school *

In which year of training you are *

Method of payment (mark your answer) *

You pay in person

The institution or company pays for you

Institution / company data

Full name of the institution/company *

Exact Address *

City *

Country *

Tax no./Reg.no. *

Final information:

Please DO NOT make payments before you receive registration confirmation and payment instructions as we will only send those when we have checked the submitted data and have a sufficient number of registered participants. If you pay before that, and it turns out that you do not meet the conditions for participation in the education or the education is canceled due to insufficient number of participants, we will be forced to refund your payment reduced, according to the General Terms and Conditions for participation in educations.

Attendance at the education will not be possible if the registration fee is not paid in full according to payment instructions and until the specified date.

In the application, state the email address valid until the end of the seminar and the issuance of the certificate (change of the email address is regulated by the General Terms and Conditions which you can read here.

Include the email addresses ordinacija@bubera.rs and natasrbije@gmail.com in your contacts in order to avoid our mail being transferred to the SPAM folder of your mail client. Periodically check your SPAM folder and, if our mail reaches the same, mark it as NOT SPAM and transfer it to your INBOX folder.

By submitting this application, it will be considered that the Contract on participation in the education has been concluded (signed) and that the Participant confirms that he is fully acquainted with and agrees with the General Terms and Conditions for participation in educations published on the website and that these General Terms and Conditions are an integral part of the Contract on participation in the education. Also participant confirms that he is fully informed about: consecutive, non-professional translation from English to Serbian and that he accepts it and that no accompanying materials – presentations, hand-outs, recordings of the education etc. are not included in the education price of 185€ (22.000 dinars).

We kindly remind you that, after you fill the form, you need to mark the field “I accept the General Terms and Conditions” and then click on the "Send" button.

ALSO CHECK your SPAM folder please, if the confirmation of your application didn't appear in your INBOX!.

I accept the General Terms and Conditions *