THIS IS NOT AN ONLINE REGISTRATION FORM - FOR PRINT ONLY            Printed Date: 3/29/2024 7:58:28 AM

Seminar Title:
5-Day Certificate Program Retreat: Attachment-Centered Play Therapy in a Retreat Setting
Seminar Date:
Sunday, August 26, 2018
Seminar Location:
PINE KNOLL SHORES, NC 28512
Seminar ID:
63589

  Required (select one)
 
EARLY BIRD REGISTRATIONS AVAILABLE THROUGH JULY 13, 2018


Single Occupancy

$1,799.00 By July 13, 2018
$1,999.00 After July 13, 2018

Double Occupancy

$1,599.00 By July 13, 2018
$1,799.00 After July 13, 2018

BONUS: Get a FREE IATP membership by attending! A $99.99 value, plus waiving the $99.99 application fee for Certification! Completion of this 5-day retreat meets the educational requirements when applying to become a Certified Child and Adolescent Trauma Professional (International Association of Trauma Professionals, www.traumapro.net)

  ________ HI, NM attendees add applicable sales and local taxes**
  ________ Subtotal (Required items + sales tax)
 
  Optional
 
$24.99 Play Therapy: Engaging & Powerful Techniques for the Treatment of Childhood Disorders
$24.99 250 Brief, Creative & Practical Art Therapy Techniques: A Guide for Clinicians and Clients
$29.99 CBT Toolbox for Children and Adolescents: Worksheets & Exercises for Trauma, ADHD, Autism, Depression & Conduct
$14.99 Mindfulness Skills for Kids: Card Deck and 3 Card Games
$99.99 The Power of Play: Proven Strategies for Treating Trauma and Attachment in Children & Adolescents 012617
  ________ AL, AR, AZ, CA, CO, CT, DC, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NJ,
NM, NV, NY, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY attendees add applicable sales and local taxes**
  ________ Subtotal (Magazines + Optional items + sales tax)
   
  ________ Total (Required subtotal + Optional subtotal)
  ** Tax-exempt customers please send a copy of your tax-exempt certificate.
  *** Registration for coordinator or military member discount must be completed online
  **** All prices are shown in US Dollars ****
 
 

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Mail or Fax to:
PESI Rehab, P.O. Box 1000, Eau Claire, WI 54702-1000      (800) 554-9775 (fax number)