application form

To become a registered Emotional First Aider, please complete the application form below. Please indicate your preferred efa course, either Primary efa for those who work with 5-11 year olds or Young People efa for those who work with 11-25 year olds.

The course reference number is located on the course finder pages. If you cannot find a course that suits you or you are interested in group bookings for your staff please contact us with your enquiry.

application form

*(denotes required field)

--- booking ---

full name:*

email address:*

course:*

training date:*

unique course ref:*

--- contact details ---

job title and agency:*

address:*

daytime contact no:*

mobile phone no:

emergency contact name:*

emergency contact no:*

Do you have a disability/special requirements that we should be aware of?:*

Yes No

If Yes, please provide full details:

--- reasons for applying---

How will knowledge you gain from the Emotional First Aid course be used in

your workplace?

--- payment details ---

On receipt of your application we will arrange for an invoice to be sent to you for the cost of the course. If you would like the invoice to be sent directly to your Manager please provide the correct details here:

name:*

address:*

contact phone no:*

--- confirm ---

In order to complete the EFA training and receive your certificate there is a minimum attendance of 83% (5 of the 6 sessions). Any participant who is absent from Session 1 will not be able to attend the rest of that course and will be placed on a subsequent course dependant on availability. Cohort delegates agree to partake in research for EFA.

By ticking this box you agree to the terms outlined above:*

Finally, if possible, please upload a copy of your line manager’s signature to confirm their agreement of your attendance on the course:

Acceptable file types: doc,pdf,txt,gif,jpg,jpeg,png.
Maximum file size: 1mb.

The efa team are based at:
CAMHS Management Team
Cumberland House
15-17 Cumberland Place
Southampton
SO15 2UY

Telephone: 023 8071 6674
Fax: 023 8063 8142

info@emotionalfirstaid.co.uk