How did you
learn about the seminar? ____Brochure ____E-mail ____Personal Contact ____ Website
_______
Assessment & Treatment of PTSD: Re-scheduled for Spring 2009 - Date
TBD
Registration: 8:15 a.m. Seminar: 8:30 a.m. - 4:00 p.m.
(Lunch on your own)
Cost: The seminar fee is $125, discounted to $99
for early registration.
Refund and Cancellation Policy: Registrations cancelled on
or before the early registration date are subject to an administrative fee of $25. No refund will
be granted after that date, but participants may apply the deposit or fee to a future
seminar.
Payment method: ______ check
______ credit card (Payable in US dollars)
Charge to: _____ MasterCard
_____ Visa Amount: $___________
Card # ________________________________ Expiration date:
_______/_______
Name on card:________________________________________________________
Cardholder signature:_________________________________________________
Fax
with credit card information to
405-691-0452 or mail
form with
check made payable to:
Oklahoma
Traumatology Institute
3037 N.W.
63rd St., Suite 150
Oklahoma
City, OK 73116
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