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Corporate / Buisness Training Request

Please complete the form below.

All information will be treated as confidential.

First name*

Last name*

Address*

Email*

Phone*

Please tell us which Health Trust you are under (for statistical purposes only).*

Northern Trust

Belfast trust

South Eastern Trust

Western Trust

Southern Trust

Are you contacting us as an individual enquiring about training or sourcing training / workshops for an organisation?*

Individual

On behalf of an organisation

Other

Contacting on behalf of - (please note, if you are an individual professional enquiring about training, visit the professional training section)

If enquiring on behalf of an organisation or buisness, please tell us which (if applicable). *

Please tell us your profession (if applicable)*

Are there particular training or workshops you are enquiring about? Please tell us which one(s)*

If you are interested in bespoke, tailored training, please tell us a bit about this -

Any other information it would be helpful for us to know?

How did you hear about our service?

Website search

Social Media

Health Care Professional

Word or Mouth

Previous attendee

Service User

Other

Preferred method of contact*

Zoom / Teams

Telephone

Other

Permission to contact

info@asafespacetobeme.co.uk

028 9620 8284

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