Youth MHFA Refresher Open Course – Richmond Foundation

NAME AND SURNAME:*

I.D. NO:*

DATE OF BIRTH:*

PERSONAL ADDRESS:*

Street Address Address Line 2 City ZIP / Postal Code

EMAIL ADDRESS*

TELEPHONE:

MOBILE:*

GENDER (As per ID card):*

Male
Female

RESIDENCE (As per ID card):*

Malta
Gozo

EMPLOYMENT STATUS:*

Employed
Self-Employed
Unemployed
Inactive
Inactive, not in education or training

Employed [Persons should be working on a part-time or full-time, or on reduced hours. Persons in “subsidised” employment should also be considered as employed. Persons currently on maternity leave should also be considered as employed.] ; Unemployed (Persons should be registered with Jobs Plus); Inactive are those persons who are neither in employment nor are they registered unemployed. Full-time students are also considered as inactive; Inactive not in education or training are those persons who are not in employment, registering for work, and/or in education or training.

NAME OF ORGANISATION (If Applicable):

Fill in only if you are attending through an organisation (company, school, NGO, etc)

PROFESSION:*

EDUCATIONAL BACKGROUND:

Level 4 Diploma
Level 5 Diploma
Level 6 Degree
Level 7 Masters
Level 8 PhD

Certificate Expiration Date*

The date shown on your MHFA certificate to indicate expiration of course taken.

Hidden

MARK YOUR TRAINING GROUP*

August Group: 21st August (9am till 1pm)

Terms and Conditions*

I have read and accept the terms & conditions including the data handling policy

1. Booking will be confirmed by Richmond Foundation further to receipt of payment. Said payment is to be made by cheque payable to ‘Richmond Foundation’ or through the online application on the Mental Health First Aid webpage. Payments must not be made later than 48 hours before the commencement of the event. Registration is subject to cheque being honoured by the Bank. 2. No refund will be given for cancellations less than 24 hours before the commencement of the event. 3. A participant can opt for a refund or attend another course date, selected by Richmond Foundation, if the participant cancels in the appropriate timeframe. If the participant will not come for the course the second time, no refund will be given and will have to reapply for the course. 4. When paying online, there is a €3 non-refundable charge. 5. Data given with the registration form will be processed in accordance with the Data Protection Act 2001 and the General Data Protection Act. 6. Certificates will only be given to those participants who attend the 12 hours of training. 7. Richmond Foundation reserves the right to cancel the training course, for example if insufficient bookings are received. In such cases participants will be offered either a refund or the choice of attending another course. 8. All materials used in this training course, including the MHFA manual which course participants will receive after the course, are copyright of Richmond Foundation. None of the materials, nor any part of the MHFA manual, may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, without prior, written permission of Richmond Foundation.