Istituto di Gestalt HCC Italy

Registration form

First name

Last name

Email

Phone

Privacy note: the following data are important to issue the final certificate (if you don't want a final certificate you can just insert a random value).

Place of birth

Date of birth (dd/mm/aaaa)

Privacy note: the following data are important to issue the invoice.

VAT code (if you want to appear on the invoice)

Address

ZIP code

City, State

Country

If your Country is not in the list please contact info@gestalt.it

Privacy note: the following data are important in order to verify previous training requirements.

Main occupation

Degree

I practice psychotherapy since

I have been trained with (or in which Institute)

Personal interest in attending the seminar

Professional ethics

I declare that I am a professional psychotherapist or in training. I respect the code of ethics of psychotherapy and I agree not to divulge the contents that will be processed in the seminar and to use them only for purposes of my personal training.
I declare that I am a professional psychotherapist or in training
I am not a professional psychotherapist or in training

By sending this form, you agree to our privacy policy

You can pay with your credit/debit card (Visa, Mastercard, American Express,...).
If you wish, you can use Apple Pay, Google Pay, Bancontact, EPS, Giropay, iDeal, Przelewy24.
You can also register now and pay in installments.

Contemporary Gestalt Therapy and Contemporary Psychoanalysis: Dialogical Bridges

Milano (Italy), November 15-16, 2024