The Early Intervention Project Workshop for Professionals and staff Application form

Please note that this workshop is aimed at professionals and staff who work with children with learning disabilities whose behaviour challenges. Challenging behaviour is a term used to refer to a wide range of behaviours which may include aggression, selfinjury, socially inappropriate or disruptive behaviours. Your details Name Email address: Postal address: Telephone number: Professional details Job title: Organisation: Length of time in current job: Number of children with learning disabilities whose behaviours challenge you have worked with in the last 12 months: Reason why you would like to attend the workshop: Any particular experience or expertise you can share with the Early Intervention Project: Do you have any training or experience in Positive Behavioural Support? Yes No Please give details: Please give any other relevant information or experience: Dietary requirements Do you have any dietary requirements? Yes No Please give details: Access requirements Do you have any access requirements? Yes No Please give details:

Please return completed applications by no later than 5pm on Tuesday 11th of February 2014 Completed applications can be returned to the Early Intervention Project at: Email: earlyinterventionproject@thecbf.org.uk Address: The Challenging Behaviour Foundation, The Old Court House, New Road Avenue, Chatham, Kent, ME4 6BE Tel: 01634 838739