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Course 1 : Click here to enter text. Date : Click here to enter a date. Course 2 : Click here to enter text. Date : Click here to enter a date. Course 3 : Click here to enter text. Date : Click here to enter a date. ** If you wish to book additional courses please identify these when you are in touch by phone or in person. Forenames : Click here to enter text. Surname : Click here to enter text. Address : Click here to enter text. Post Code : Click here to enter text. Email : Click here to enter text. Telephone : Click here to enter text. How would you prefer to be contacted: Phon e Emai l Text Post Othe r How did you hear about us? Word of Mouth Publicity Health Professional Web other (please specify) ________________ Is there anything that might impact on your attendance, access, participation or learning needs we should know about?

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Page 1: api.ning.comapi.ning.com/files/3oOh0daNY6...  · Web view☐ Word of Mouth ☐ Publicity ☐ Health Professional ☐ Web ☐ other (please specify) _____ Is there anything that

Course 1 : Click here to enter text. Date : Click here to enter a date.

Course 2 : Click here to enter text. Date : Click here to enter a date.

Course 3 : Click here to enter text. Date : Click here to enter a date.

** If you wish to book additional courses please identify these when you are in touch by phone or in person.

Forenames : Click here to enter text.

Surname : Click here to enter text.

Address : Click here to enter text.

Post Code : Click here to enter text.

Email : Click here to enter text.

Telephone : Click here to enter text.

How would you prefer to be contacted:

☐ Phone ☐ Email ☐ Text ☐ Post ☐ Other

How did you hear about us? ☐ Word of Mouth ☐ Publicity ☐ Health Professional

☐ Web ☐ other (please specify) ________________

Is there anything that might impact on your attendance, access, participation or learning needs we should know about?

Page 2: api.ning.comapi.ning.com/files/3oOh0daNY6...  · Web view☐ Word of Mouth ☐ Publicity ☐ Health Professional ☐ Web ☐ other (please specify) _____ Is there anything that

Individual Learning Plan

We would recommend that you come in to talk with us about your personal goals or talk with us over the phone. Please contact us to make an appointment: [email protected] or (01387) 345866

Name : Click here to enter text.Hopes, goals & ambitions

Click here to enter text.

Date: Click here to enter a date.

Send your completed booking form to:

For office use Y/N Appointment date/time Attended

Meeting

TelephoneCompleted by:

Marjory McCallum, Project Administrator Dumfries & Galloway Wellness and Recovery

College, Dudgeon House, Bankend Road

Dumfries DG1 4ZN or by email [email protected]

Confirmation of your place will be made by post or email. If you have any questions please do not hesitate to get in touch. Your registration details will be stored securely in accordance with data protection law and used solely for the purpose of managing and monitoring the college.

The college would like to send you updates on other courses and DGWRC news. If you do not wish to be added to our mailing list please tick here