Asian Academy of Family Therapy Limited AAFT - Application Form Marriage & Family Therapy Clinic: Live Case Demonstration (Spring 2020)

Please fill in all * Required blanks

Personal Information

Prefix

Mr.

Ms.

Mrs.

Dr.

Prof.

Name of Applicant *

Work/Home Address

Contact no. *

Fax no.

Email *

AAFT Membership no. (if any)

Education

Highest Degree Acquired *

Year Attained *

Institute *

Profession *

Clincial/Educational Psychologist

Counselor

Doctor (Family Physician/Pediatrician/Psychiatrist)

Nurse (Psychiatric/General)

Occupational/Physiotherapist/Speeh Therapist

Reseach Assistant/Officer

Social Worker

Student Guidance Officer

Teacher

Student

Others

Working Experience

Current Organization *

Position *

Nature of Service *

No.of service in the field

Please indicate the date of session *

18 Apr 2020

2 May 2020

9 May 2020

23 May 2020

6 June 2020

Have you ever attended our live case demonstration sessions before

Yes

No

Reasons for Interest in the Live Case Demonstration

For the benefit of the current job

Interested in pursuing a career in family therapy

For personal growth

Interested in taking formal training in family therapy

Self-interest

Others

The way You Learnt About Us

Website

Email

Leaflet

Friends

Schools

Newspaper

Social service agancy

Hospital/Clinic

Others

Fee *

1 session (members of the AAFT) HKD500

2 session (members of the AAFT) HKD1000

3 session (members of the AAFT) HKD1500

4 session (members of the AAFT) HKD2000

5 session (members of the AAFT) HKD2500

6 session (members of the AAFT) HKD3000

7 session (members of the AAFT) HKD3500

8 session (members of the AAFT) HKD4000

1 sessions (Non-members of the AAFT) HKD550

2 sessions (Non-members of the AAFT) HKD1100

3 sessions (Non-members of the AAFT) HKD1650

4 sessions (Non-members of the AAFT) HKD2200

5 sessions (Non-members of the AAFT) HKD2500

6 sessions (Non-members of the AAFT) HKD3000

7 sessions (Non-members of the AAFT) HKD3500

8 sessions (Non-members of the AAFT) HKD4000

Total Amount: HKD 0