Support Group for Alcohol Addiction Application Form

First Cycle Period

First Cycle:

Monday, 7th March to Monday, 18th April 2022

Application Period:

Monday, 17 January to Monday, 28 February 2022

Frequency and Time for Online Encounters:
Mondays, between 14:30 and 16:00 pm

Second Cycle Period

Second Cycle:

Monday, 5 September to Monday, 31st October 2022

Application Period:

Monday, 2 May to Thursday, 30 June 2022

Frequency and Time for Online Encounters:
Mondays, between 14:30 and 16:00 pm

Cycle Duration *

First Cycle: Monday, 7th March to Monday, 18th April 2022
Second Cycle:Monday, 5 September to Monday, 31st October 2022

Please select which cycle interests you.

Applicant's Particulars

Name *

First

Last

Please add your First name and Last Name

Profession *

Please add your Profession

Email *

Please add your Email

Phone *

Please add your Mobile Number

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Participation Cost ( Non Refundable) *

Price: 160,00 €

I declare and pre-pay for my individual participation in the Cycle and I understand fully that, in case the need arises to discontinue my participation in the Cycle, the amount I have paid will not be refunded to me.

GDPR Agreement *

I consent to having this website store my submitted information so they can respond to my inquiry.

Cookie	Duration	Description
cookielawinfo-checkbox-analytics	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Analytics".
cookielawinfo-checkbox-functional	11 months	The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional".
cookielawinfo-checkbox-necessary	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookies is used to store the user consent for the cookies in the category "Necessary".
cookielawinfo-checkbox-others	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Other.
cookielawinfo-checkbox-performance	11 months	This cookie is set by GDPR Cookie Consent plugin. The cookie is used to store the user consent for the cookies in the category "Performance".
viewed_cookie_policy	11 months	The cookie is set by the GDPR Cookie Consent plugin and is used to store whether or not user has consented to the use of cookies. It does not store any personal data.

First Cycle Period

Second Cycle Period

Applicant's Particulars

The psychosocial components of self and self-esteem

Gordon Allport

Sibling quarrels