APPLICATION FOR A STARFISH COURSE

Please answer all questions as frankly and honestly as possible.

Your answers are handled in the strictest confidence and are to assist us in helping you on a course.

* denotes a required field

Your Details

Your telephone number is very important to us, as we need to discuss your course with you. PLEASE ENSURE YOU INSERT IT ABOVE.

We do appreciate that the telephone is a problem for some people who stammer. However, please remember that we speak to more people who stammer, applying for a Starfish course, than people who do not. We are only interested in what you have to say, not how you say it.

About You

Please answer all questions as frankly and honestly as possible, your answers are handled in the strictest confidence and are to assist us in helping you on a course.

Previous Therapies / Date / Method(s) used
How did you hear about The Starfish Project?

To enable us to reach more people who stammer could you please tell us, how you heard about The Starfish Project ?

Prefered Course Dates

Starfish Project Courses are held regularly throughout the year. To enable us to schedule a suitable date for you please let us know dates that you are available for a course. We will then discuss a mutually convenient time with you.

The most suitable course date for me would be.
Or

Sometimes a course place is available at short notice, we will contact you if a place becomes available.

Application confirmation

I wish to apply for a place on a intensive therapy course organised by The Starfish Project.

I confirm that I have read and understood the literature provided to me by The Starfish Project and that the information that I have provided will be treated in the strictest confidence by The Starfish Project.

I appreciate that though The Starfish Project has had a beneficial effect for other stammerers , it offers no guarantee of recovery from or a cure for stammering. The Starfish Project will not be responsible for any direct or consequential effects which may arise from my participation in its programme.

Covid 19 safety measures on Starfish Project courses

To protect the health of everyone on a Starfish course we have sought professional health and infection control advice. Based on that advice, we have implemented various safety measures for the safety of everyone on a course. Everyone attending a Starfish residential course will be required to have received both 1st and 2nd Covid vaccinations, with the 2nd vaccination received a minimum of 14 days before the course start date. Everyone will be required to show proof of their vaccinations either electronically (with the NHS app), or a doctor’s letter confirming the vaccinations. Everyone will be required to follow the safety measures on a course for our mutual protection.

In the case of a Young Person Name of Parent/Guardian
Please click on the submit button below to complete your application.