Aware NI - Mood Matters Adult - Resistration Form

Mood Matters - Adult - Registration of Interest

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Age Group (*)

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Please provide us with a phone number in case we need to contact you about this course

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Personal Email(*)

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Home Address Details

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Please state below if you have any access requirements: (including help with reading and writing)?

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Is there any other information you feel is relevant to your application?

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GDPR Agreement

We really appreciate your ongoing support of our cause. We would love to tell you occasionally about events and campaigns going forward. You can always unsubscribe at any time and can choose how you would like us to contact you. We will never sell your details to another organisation and they will be held securely and confidentially. To read our full privacy notice contact it is available on the website here: Privacy Policy

Course Agreement

I wish to apply for a place on the above course. If requested, I agree to provide information, which will assist in the overall evaluation of the programme. I understand that any such information will be provided anonymously, will be treated in the strictest confidence and will not be used for any other purpose.

Please tick the box to signify that you agree(*)

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AWARE is the depression charity for Northern Ireland and the only charity working exclusively for those with depression and bipolar disorder.

Aware Defeat Depression, known as AWARE, Crawford Square, Derry/Londonderry, BT48 7HR, Company No: NI30447. Registered with the Charity Commission for Northern Ireland with charity registration number NIC100561

BELFAST OFFICE

Tel: 028 9035 7820

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DERRY/LONDONDERRY OFFICE

Tel: 028 7126 0602

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info@aware-ni.org

Mood Matters - Adult - Registration of Interest

GDPR Agreement

Course Agreement

BELFAST OFFICE

DERRY/LONDONDERRY OFFICE