1. Emotional First Aid Dear Emotional First Aider, We are pleased to announce that your Train the Trainers’ course will take place on 10 th and 17 th March 2011 or 18 th and 25 th March 2011 from 9.00am and 5.00pm. Lunch and refreshments are provided. Participants will be paired up with others and will be expected to meet in the week between the two training dates to prepare teaching material as part of the course. You must be able to commit to both full days training in order to graduate and be awarded their EFA Trainer’s license. As a qualified Emotional First Aider you are eligible to apply to become a licensed EFA Trainer. So far we already have 40 licensed Trainers within the city and you could join them to promote Emotional First Aid amongst your colleagues or even as a private Trainer! Once you are licensed as an EFA Trainer, the benefit for your organisation is a reduced in-house training cost for staff from £300 to £50 per head. This covers the cost of the pizza boxes which you purchase from Southampton Community Healthcare (a minimum order of 10 pizza boxes is required). The EFA Trainer’s license will be valid for one year and is automatically renewed once the trainer has run a minimum of two courses within that period. Please be aware that if you are delivering the training to anyone who is not employed within your organisation or the organisation of a co-trainer, the minimum charge of £300 per head applies. If you would like to apply for the Emotional First Aid Train the Trainers’ Course, please complete the attached application form and return it to: Ally Krause Emotional First Aid Administrator Cumberland House 15-17 Cumberland Place Southampton SO15 2BG

2. EMOTIONAL FIRST AID TRAINER’S APPLICATION FORM CONTACT DETAILS Required Training Dates: Name: Job Title & Agency: Address: Daytime Contact No: Mobile No: Email Address: EMERGENCY CONTACT DETAILS Name: Contact Telephone No(s): Office use only SOUTHAMPTON Candidate No:Cohort No:

3. WHY HAVE YOU DECIDED TO APPLY Please say why you are applying to become an EFA Trainer? What do you hope to gain from attending this course? What do you think are the key messages of the EFA course? Who do you plan to deliver the EFA training to and how do you hope it will benefit their practice? CONSENT Please ask your line manager to confirm their agreement of your attendance on the course by signing below Manager’s signature Applicant’s signature Date BY YOU AND YOUR LINE MANAGER SIGNING AND RETURNING THE FORM YOU ARE AGREEING TO ATTEND THE TWO FULL DAYS TRAINING AND TO BE A PART OF OUR EMOTIONAL FIRST AID RESEACH. Please return your completed form to the address above, thank you. On completion of the course, in order to receive your trainers licence, you will be required to sign a licence agreement which ensures the integrity and fidelity of the course for any participants who attend your EFA training.