Booking Form

Booking form

* Indicates required field

First name *

Last name *

Street or PO Box No. *

Suburb *

Postcode *

Email *

Confirm email *

Preferred telephone / contact number *

Occupation *

If other: *

Course Dates 2019 *

When you attend a HeadRest course you will receive a number of emails. These include logistical information, course notes/home practices mp3s etc. You will also receive a newsletter which references mindfulness, research, tips, recordings and information about future courses. If you are booking a course these emails are an essential part of the course content. Of course, you can unsubscribe from the newsletter at any time.

I give HeadRest permission to send me the above emails *

Do you have any comments or questions? *

MBSR Registration will be assured when you both submit this form and pay for the course. If you are enrolling in a PSS funded course, there is no fee but your place will only be confirmed after we have spoken to ensure the group meets your needs and with GP referral. I'll be in touch once you have submitted a form.

The 2019 course fee for MBSR, LCWM and Mindful Parenting is $580.00.
There is an early bird discount of $70.00 off the full fee only if payment is 4 weeks prior to the course commencing.
Cost for FT students or those on a Centrelink benefit is $365.00. It is my hope that course fees should not be a barrier to participation. As such, some subsides may be available. Please let me know if you require a subsidy.
The cost for the refresher course is $250.00. If you are on a Centrelink benefit or will struggle to pay this fee please be in touch to organise a subsidy.

Minimum course numbers
If less than 10 people enrol in the course I may decide to not run the course. In this case I'll contact you at least 1 week prior to the course commencing. So far all evening courses have all run beginning in 2014. The morning course can be light on numbers. If you are interested enrol early to ensure the course takes off. Call me if you would like to discuss this

Day of Mindfulness only
The fee for the day of Mindfulness for returning students is $35.00. There is no fee if you are currently enrolled in a course or on a Centrelink benefit.

6-week MBSR refresher course
The fee for this course is $250.00. Please let me know if you require a subsidy to make attending affordable.

Monthly Practice Group.
The fee for all 3 classes is $75.00, $60.00 for 2 classes or $35.00 for individual classes.The concession price is is $35.00 for 3 classes or $15.00 per class.

To pay please deposit the required fee :
Tienne Simons
BSB: 923100
Acc No: 32994084

When you deposit the money please send me an email headrestgroups@optusnet.com.au to let me know you have made the deposit. I'll be in touch soon after.

I look forward to meeting you in the course.

Tienne Simons

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