Support Group for Smoking Cessation Application Form

First Cycle Period

First Cycle:

Saturday, 5 March to Saturday, 30 April 2022

Application Period:

Saturday, 15 January to Sunday, 20 February 2022

Frequency and Time for Online Encounters:
Saturdays, between 14:00 and 15:30 pm

Second Cycle period

First Cycle:

Saturday, 3 September to Saturday, 29 October 2022

Application Period:

Sunday, 1 May to Monday, 27 June 2022

Frequency and Time for Online Encounters:
Saturdays, between 14:00 and 15:30 pm

Cycle Duration *

First Cycle: Saturday, 5 March to Saturday, 30 April 2022
Second Cycle: Saturday, 3 September to Saturday, 29 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.

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First Cycle Period

Second Cycle period

Applicant's Particulars

The psychosocial components of self and self-esteem

Gordon Allport

Sibling quarrels