safeTALK Suicide Prevention Training – Registration (2 pax) SafeTALK 2-pax Registration August 2024 Intake for the Blind and Low Vision community You can find more details on our safeTALK Suicide Prevention page (opens a new window) Registering for 1 pax? Head to our registration page for 1 pax(opens a new window) If you have any questions, head to our Frequently Asked Questions page (opens a new window) All submissions will remain confidential, and only authorised members of the Equal Dreams team have access to them. Part A: Contact Information Full Name * This will be the name for your certificate of completion Full Name of 2nd pax * This will be the name for your certificate of completion Preferred Name * How you’d like to be addressed Preferred Name of 2nd pax * How you’d like to be addressed Email * Email of 2nd pax * Contact Number * Contact Number of 2nd pax * Age * Age of 2nd pax * Part B: Getting to know you How are you affiliated with the blind and low vision community? For 2nd pax: How are you affiliated with the blind and low vision community? What is your current occupation? * e.g your field of study and/or current sector you are working in For 2nd pax: What is your current occupation? * e.g your field of study and/or current sector you are working in Why do you want to join this programme? * For 2nd pax: Why do you want to join this programme? * Do you require access arrangements? For 2nd pax: Do you require access arrangements? How did you get to know about this programme? You can select multiple answers from a list of choices. * Equal Dreams Website Equal Dreams Social Media Equal Dreams Mailing List Search Engines Word of Mouth OtherOther Part C: Consent for 1st pax I consent to receiving information about new programmes, events or sharing sessions via email. * Yes No I consent to being photographed and having my image and/or likeness used for the purposes of promotional materials, including but not limited to programmes, website content, and social media publicity. * Yes No * I consent to the collection, use and/or disclosure of my personal data by Equal Dreams from time to time, for the purposes of this training programme to Equal Dreams, which includes course administration, collation of feedback, research and analysis, and any other purposes necessary and/or relevant to the above in accordance with the Personal Data Protection Act (PDPA). * I confirm that the data I have provided above is accurate and complete at the time of submission. Part C: Consent for 2nd pax I consent to receiving information about new programmes, events or sharing sessions via email. * Yes No I consent to being photographed and having my image and/or likeness used for the purposes of promotional materials, including but not limited to programmes, website content, and social media publicity. * Yes No * I consent to the collection, use and/or disclosure of my personal data by Equal Dreams from time to time, for the purposes of this training programme to Equal Dreams, which includes course administration, collation of feedback, research and analysis, and any other purposes necessary and/or relevant to the above in accordance with the Personal Data Protection Act (PDPA). * I confirm that the data I have provided above is accurate and complete at the time of submission. Payment Please make payment for 2 pax: safeTALK Suicide Prevention Training: $ 50.00 Discount code (read only) Discount Amount (read only) How would you like to pay by? * PayNow (Recommended) Credit/Debit Card PayNow to UEN 202301134M (Entity Name: EQUAL DREAMS PTE. LTD.) Total Payment Payment Information * Please upload the screenshot of your receipt as proof of payment. * Drop a file here or click to upload Choose File Maximum file size: 516MB Submit If you are human, leave this field blank.
