Registration: EMDR Recent Event Protocols for Man-Made & Natural Disasters (23 Feb 2024)

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REGISTRATION INSTRUCTIONS:
(1) Complete this form in its entirety.
(2) Email a digital copy of your EMDR Basic Training certificate to LouisianaTRN@gmail.com.

(3) To purchase CEUs, make check out to CASH and mail to Averie McCauley at 4833 Conti St, Ste 210, New Orleans, LA 70119.

Questions? Email LouisianaTRN@gmail.com

Email *

Name *

Phone *

Address *

Professional License Number
*

Professional License Type
*

LCSW-BACS

LCSW

LMSW

LPC-S

LPC

PLPC

Other:

Check all that apply regarding CEUs. *

I am a current TRN volunteer and would like EMDRIA CEUs ($0).

I am a current TRN volunteer and would like Professional CEUs ($0).

I am a current TRN volunteer and would like EMDRIA and Professional CEUs ($0).

I do not intend to receive CEUs.

I am purchasing EMDRIA CEUs ($25).

I am purchasing Professional CEUs ($25).

I am purchasing EMRIA and Professional CEUs ($35).

Required

Registration Checklist *

This form is completed in its entirety.

A digital copy of my EMDR Basic Training certificate is on its way to LouisianaTRN@gmail.com.

If purchasing CEUs, a check made out to CASH is on its way to Averie McCauley at 4833 Conti St, Ste 210, New Orleans, LA 70119.

Required

A copy of your responses will be emailed to the address you provided.

Submit

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