CONTACT DETAILS


Name *
Preferred first name (for nametag) *
Address *
Email *
Phone (no spaces or hyphens please) *
-

NB: If entering a mobile number, simply enter '04' in the 'Area code' field above, then the rest of the number in the second field.


PERSONAL DETAILS


Occupation *
Faith Community Affiliation *
Any special dietary needs (these details are required for the residential retreat) – please type 'None' if you have no special requirements. *

FORMAL STUDY AND VOCATIONAL TRAINING


Please list all formal study and vocational training *

YOUR INTEREST IN THIS COURSE


What do you see as the benefits for you, what attracts you about this course, etc.? *

YOUR BACKGROUND IN THIS AREA


What is your background in this area? *

YOUR UNDERSTANDING OF CONTEMPLATION


Briefly describe your own understanding of Contemplation *

NB: Some people have advised us that they have had trouble submitting this form.

If your form is successfully submitted, you should then be redirected to a screen thanking you for your registration.

If this confirmation page does not appear, this may mean that your computer has not submitted your registration successfully. If this is the case, please email Monique at info@wellspringcentre.org.au to check if your registration has been received.