Register for Residential Training

Select Residential Training Program*

5 Day
7 Day
VITAL 2 Advanced

Your details

Name*

FirstLast

Preferred / Nickname

Permanent address line 1*

Suburb*

State*

Post code*

Home phone

Work phone

Mobile phone*

Primary Email*

Another Email (as backup)

Gender*

Employer (if applicable)

Your role or position

Has your Spouse/Partner attended a 5 or 7 Day?*

Yes
No

Who do you know that has attended a VITAL Training?

Invoicing details

Please select a price category:*

Category 1: Donation-based organisations without training funding
Category 2: a) Donation-based organisation with training funding
Category 2: b) Non Donation-based organisations

(Cat. 1 are subsided by VITAL fundraising efforts)

Invoice to (name of person or role)?*

Invoice/s to Organisation/s

Invoice email*

Invoice contact phone*

Invoice contact address line 1*

By the end of this training program I would like to leave with what specific (skills, knowledge, experience etc)*

No Limits training kits (ages 15-18+) - Order separately*

Please head to Resources Page to order this https://www.vitalprojex.com/resources/training-kits/

Unlimited training kits (ages 10-14) - Order separately*

Please head to Resources Page to order this https://www.vitalprojex.com/resources/training-kits/

Tell us about yourself

Briefly describe the specific responsibilities of your work including previous experience and any training...*

To what application do you envisage using these skills?*

What are some of your major interests, skills and passion?*

By the end of this training, I would like to leave with the following skills, knowledge, experience:*

Skills, knowledge or experience

Your response to the following questions will assist in the emphasis of the program. From your honest perception - please rate your level of skills, knowledge or experience in the following areas on a scale of 1 to 5, with 1 being limited experience and 5 being extensive experience.

Group facilitation and group processes*

Effectively communicating with Community leaders*

Effectively communicating with Business people and education sector*

Effectively communicating with Young People*

Training & equipping others*

Experience in counselling or mentoring*

Statement of Commitment*

I agree

By submitting this form, I acknowledge a sincere desire to be involved in this course and do my utmost in respect for myself and others to gain the maximum benefit from this program.

Media Consent

I agree
I do not agree

I am also OK about being photographed /videoed during the program and respectful images or any endorsements I submit may be used in future promotion.

Name*

FirstLast

Date*