ZAP Application Form

Please study the advice on our website before applying for this course. You will need to obtain a copy of your school's Anti-Bullying Policy and put the advice to parents and bully log sections into operation first. If the case is extreme (i.e. a threat of suicide or self-harming) we will try to fast track your application.

* indicates required entry

*Parents Name:	Required entry
*Child's Name:	Required entry
*Child's DOB:	Required entry
Address :

City or Town :
Country:
*Postal Code:	Required entry
* Phone: (our preferred method of contact)	Required entry
Fax:
Email:
*How did you hear of ZAP?	Please select an item.
Other
Details of your child's special circumstances We require some background information on all potential ZAP participants*. Please give us as much detail as possible about your child's bullying experiences. We also need to know if s\he has Special Educational Needs, relevant medical conditions or other emotional factors.
Required entry
Please note that in certain exceptional cases, ZAP sessions may not be appropriate for your child.

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ZAP

ZAP Application Form

*Details of your child's special circumstances

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