Systems-Centered® Training Workshops, London
 June 2015

Application Form
Name	
	
Address	

	
Contact telephone no.	
	
Email address	
	
My name and email can be shared with	Other participants                                        Yes/No
	
	SCTRI administrator for further info about SCT events             Yes/No
	
Occupational or profession 	
	
How did you hear about this event?	

Fees
There are different price options for SCTRI Members and Non Members, if you are unsure whether you are an SCTRI Member, please contact Sharon Harrison (sharon.harrison@york.ac.uk) before booking 
	Booking before
1 May 2015	Booking after
1 May 2015	10% Discount for 
2 courses
Before 1 May	10% Discount for 
2 courses
After 1 May	
SCTRI Member	£295	£340	£531	£612	
Non Member	£345	£390	£621	£702	

Courses
	Please tick	
Working with Differences – Building a Systems-Centered System: Led by Susan Gantt
Dates: 8 – 9 June 2014 (see question below)		
Please state whether you are taking a Container role in the above course		
Giving and Receiving SAVI Feedback: Led by Fran Carter & Rowena Davis
Dates: 8 – 9 June 2014		
Making Work Roles Work (For us and our organisations): Led by Susan Gantt
Dates: 10 - 11 June 2014		
Putting SAVI To Work: Applications Practicum
Dates: 10 - 11 June 2014		

Payment options:

If you wish to pay by invoice, please complete the section below
Please note that invoice payments incur an admin fee of £10 per invoice raised

Customer name to be invoiced		
Contact person in organization	
	
Organization billing address	

	
Company VAT number *	
	
Tel. No.	
	
Purchase order number *	
	
Invoice amount	

If you wish to pay by cheque, please send your cheque with this application form
Please make cheques payable to University of York
(please tick if you are enclosing a cheque)  □

Value of cheque: ----------------------------------------------

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Please return application form by email or post to:		

Sharon Harrison
Department of Social Policy and Social Work
University of York
Heslington
York
YO10 5DD

Email: sharon.harrison@york.ac.uk	
Tel: +44 (0) 1904 321234	 

SCT® and Systems-Centered® are registered trademarks of Dr. Yvonne M. Agazarian and the Systems-Centered Training and Research Institute Inc., a non-profit organisation. SAVI® is a registered trademark of Yvonne Agazarian, Claudia Byram, Fran Carter & Anita Simon.