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Caring for traumatized people and the professionals who work with them...


 

 

                        

PRINTABLE REGISTRATION FORM

Name:

Employer:

Address:

Phone:

E-mail:

Field of Practice:                                                            Credential:

How did you learn about the seminar?  ____Brochure  ____E-mail  ____Personal Contact   ____ Website
 
______ Risks & Rewards of Working with Traumatized People, October 10, 2008 (6 CEUs)
Registration: 7:45 a.m.  Seminar: 8:00 a.m. - 5:00 p.m.
(Lunch on your own)

Cost:  $125. Workshop fee is discounted to $99 (Student rate: $65) if registration is received on or before September 26th. For five or more registering prior to September 26th, from the same agency at the same time, the workshop fee is $85 per person. Registration fee includes handouts and a self-test for compassion fatigue. Refund and Cancellation Policy: Registrations cancelled by September 26th are subject to an administrative fee of $25. No refund will be granted after September 26th but participants may apply the 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
 

 

 

 

 

 

 

 

Copyright © 2008 Oklahoma Traumatology Institute