ADMISSION & REGISTRATION FORM

INFACT – INTERNATIONAL SCHOOL FOR FOOD ADDICTION COUNSELING AND TREATMENT

FOOD ADDICTION COUNSELOR TRAINING
REGISTRATION FORM
Please submit by September 1st. 2019. Please type, or write legibly.
Name:
Address:
Telephone:
E-mail:
Place of Employment:
Documents to be sent with application:
1. History of education and work training, qualifications, specializations, 12 step knowledge and participation.
2. Two letters of recommendation.
3. Please write about your interest in the program and what you hope to accomplish with it
___________________________________________________________________________ Requirements for participation, graduation and certification:
1. Certificates and confirmations for education, work training and/or 12 step work and participation that may complement Food Addiction Counseling.
2. An interview with Esther Helga Gudmundsdottir, Director of INFACT.
3. For the online part of the training: computer with audio, video and stable Internet connection.
4. Knowledge of the English language.
5. Active live participation in course, presentation of a final project, weekly submission of assignments and activities, passing of final examination.
6. A signed code of ethics agreement for Addiction Counseling.
Payment options
  • Price for intensive and training: US$ 3.500.-  (10%early bird discount US$3.150)

Please circle your payment-choice: I will pay in full / Pay Pal / Money/Bank Transfer / Credit-card / Other ways of payment.

INFACT, Sidumuli 33, 108, Reykjavik, Iceland
You may also Email a completed form to esther@mfm.is

Date:
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