2024 June MST-CAN Orientation training

MST-CAN Orientation training - 4 days
24 - 27 June 2024

First name *

Family name *

Date of birth *

Only for Dutch and Belgium participants: please choose HBO or WO

Only for Dutch and Belgium participants: Year of graduation

Role in MST-CAN team *

therapist

supervisor

crisis caseworker

psychiatrist

Name MST-CAN Expert *

Name MST team * Name MST team

if your team is not listed or if you are not a Dutch or Belgium participant, please select 'other'

Name agency or organisation *

Notice: Due to EU Data Protection Regulation (GDPR) we only keep business data. We will delete private data after the training.

Business phone number *

Business email address MST-candidate (if not yet available; please provide private address)br>for confirmation and preparatory mail *

Business e-mail MST-CAN supervisor *

Permission to use photos *

Yes, MST Netherlands and Belgium may use photos that I am on.

No, MST Netherlands and Belgium may not use photos that I am on.

During the MST training, workshop and boosters in The Netherlands and Belgium, we occasional take photos to promote MST. For example on the website, newsletter, fact sheets, social media, etc. etc. Let us know if we can use the photos that you are on? When selecting the photos, we of course make sure, that everyone is looking their best.

Billing address
(Dutch partipants do not need to fill out billing address)

Billing address <br> (Dutch partipants do not need to fill out billing address)

Name organisation

Address

Zip/Postal

City

Country

VAT number organisation (only if you are not a Dutch or Belgium participant)

MST-CAN Orientation training - 4 days24 - 27 June 2024

Notice: Due to EU Data Protection Regulation (GDPR) we only keep business data. We will delete private data after the training.

MST-CAN Orientation training - 4 days
24 - 27 June 2024