Understanding and Treating Trauma - Feb 2019
A Five-Week Training Seminar with Elliott Counseling Group
Feb. 2nd, Feb 16th, March 2nd, March 16th, March 30th.
What is your first name?
What is your last name?
What is your date-of-birth?
What is your street address? Please include city, state, and zip code.
What is your email address?
What is your phone number? We will contact you to confirm your spot in the workshop.
Where is your current place of employment or organization?
What is your profession and licensure?
Are you wanting to receive the 15 CEUs?
Please state below what form of payment you will be making.
The cost for the workshop is $300. The cost for non-for-profit employees is $250. We are excepting the payment by check or credit card. To pay by check, please mail in and make payable to: Elliott Counseling Group. To pay by card, please call our offices. Payment is due in full.
How did you hear about the seminar?
What is today's date?
Send me a copy of my responses
Your submission is being processed. Please do not close this browser window until complete.