Counselling, Psychotherapy and Community Voice

Illawarra Gestalt Centre

Application Form

Name                                                                        

Address                                                                                                                                                                         

Suburb                                                                                                                         postcode                               

Telephone:          Home                                       Work                                        Mobile                   

Email                                                                                                                                                                                               

Please complete the details below and tick boxes where appropriate

Send application and payment to:         

Illawarra Gestalt Centre    PO BOX 177, Wollongong,  NSW 2520.

Make all cheques payable to:  Illawarra Gestalt Centre

ABN 73 355 220 037         For Enquiries: 02 4228 0132  0409 280247

Refund Policy

Once applicants are accepted into the course, the final payment is due 14 days before the commencement of the workshop. Any deposit or prepayment is subject to a cancellation fee of $25 dollars if notice is given before 14 days of the workshop commencing. No refunds will be provided after that.