JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Registration: Congruence Couple Therapy Foundational Series June 2024
MONDAY and FRIDAY in June 2024 – June 3 & 7; June 10-14; June 17-21
6-8 p.m. EDT
Sign in to Google
to save your progress.
Learn more
First Name, Last Name
Your answer
Email
Your answer
Phone Number
Your answer
Organization Affiliation
Your answer
Country
Your answer
Type(s) of Clients you Work With
Your answer
Highest Degree/ Level of Education
Your answer
Licensure/ Registration with Professional Association
Your answer
Registration
Early Bird registration on or before April 26, 2024: $375 CAD plus 5% GST = $393.75 CAD
Regular registration: $399 CAD plus 5% GST = $418.95 CAD
Student registration: $335 CAD plus 5% GST = $351.75 CAD
Other:
Clear selection
Confidentiality Agreement: I agree to keep the names and any shared information shared in the training confidential and not discuss them with anyone outside of the group.
Yes
No
Clear selection
Registration
I will pay by Interac-transfer to
abimft@gmail.com
I will pay through PayPal for conversion to CAD
Other:
Clear selection
Comments or Questions:
Your answer
THANK YOU for your registration! We will send you the Congruence Couple Therapy e-workbook and receipt when your registration is complete.
Option 1
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms