THIS IS NOT AN ONLINE REGISTRATION FORM - FOR PRINT ONLY            Printed Date: 10/17/2019 7:16:29 PM

Seminar Title:
Rewire the Anxious Brain: Neuroscience-Informed Treatment of Anxiety, Panic and Worry
Seminar Date:
Wednesday, July 17, 2019
Seminar Location:
HARRISBURG, PA 17101
Seminar ID:
71828

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$229.99 Single Registration
$199.99 2+ Group Rate: per person
$189.99 5+ Group Rate: per person
$115.00 Student
  ________ HI, NM attendees add applicable sales and local taxes**
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  Magazine Subscription
 
$12.99 Psychotherapy Networker Magazine Subscription - 1 Year (Full Price $36.00)
 
  Optional
 
$24.99 CBT for Anxiety: Step-By-Step Training for the Treatment of Fear, Panic, Worry and OCD
$29.99 The Anxiety, Worry & Depression Workbook: 65 Exercises, Worksheets & Tips to Improve Mood and Feel Better
  ________ 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**
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  ** Tax-exempt customers please send a copy of your tax-exempt certificate.
  *** Registration for coordinator or military member discount must be completed online
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PESI Rehab, P.O. Box 1000, Eau Claire, WI 54702-1000      (800) 554-9775 (fax number)