Counselling Service Application Form 輔導服務申請表

Counselling application form 輔導服務申請表

  • Counselling Services 所需輔導服務
  • Preferred Counsellor 選擇合適的輔導員
    • Full Name (Male) 姓名 (男)
    • Phone 電話
    • Email 電郵
    • State 省份
    • Language 語言
    • Religion 信仰
    • Church 教會
    • Full Name (Female) 姓名 (女)
    • Phone 電話
    • Email 電郵
    • State 省份
    • Language 語言
    • Religion 信仰
    • Church 教會
  • Counselling fee 輔導費用
  • Counselling fee charged by counsellor is $100 per session

    輔導員收取輔導費為每次 $100 (Subsidy is provided by MFFC 資助由「澳洲家新」提供)

  • Subsidy Condition資助條件:

    *Pre-marital counselling 婚前輔導 - Eligibility 資格:One of applicants is Christian 其中一申請人是基督徒

    Coverage 範圍:Free PREPARE/ENRICH Assessment (value $46) 免費提供 PREPARE/ENRICH測驗問卷(原價 $46)

    **Marital counselling 婚姻輔導 - Eligibility 資格:Have attended MER or Pastor referral 參加過MER營會 或 教牧推薦

    Coverage#1 範圍:Subsidies Counselling fee $50/section, maximum 5 sections 資助輔導服務費用$50/次,最多5次 (Apply to Sydney & Melbourne)

    Coverage#2範圍:Subsidies 50% of Counselling fee, maximum 5 sections 資助50% 輔導費用,最多5次(Apply to Brisbane)

  • Subsidy 資助
  • Attended MER參加 MER 營會時間
  • Referral Pastor推薦牧師姓名
  • Additional information 額外資料
  • How did you know about this service 如何得知此服務
  • If others 如其他, please specify 請註明:
  • Terms and Conditions接受輔導服務之條件:

    1.The couple must both come for the service. Once the service terminates, the couple has to re-apply for new service;輔導過程必須兩人一同參加。輔導一經停止,須再另行申請;

    2.MFFC reserves the right to support or decline the sponsorship; 本會有權決定是否贊助此輔導服務;

    3.MFFC reserves the right to terminate this service; 本會有權隨時終止此服務;

    4.The personal information above is only for internal use and will be kept with strict confidentiality;以上資料絕對保密,只供本會紀錄及輔導人員參考;

    5.Please pay the counselling fee to the counsellor directly, MFFC receives no fee for this service.服務收費直接交予輔導員,本會並無收取任何費用。

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