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EFT Event Registration 2
Lindsay Swan
2020-03-04T17:21:53+00:00
Workshop Name:
*
Name:
*
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Address:
*
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Phone:
*
Email:
*
License Type:
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LICSW
Lic. Psychologist
LMFT
LMHC
Student or Unlicensed Professional
Other (please describe):
*
Agreements:
*
I have the training and educational qualifications to legally practice as a professional mental health practitioner or I am in formal training to be a professional mental health practitioner.
I have previously completed the Externship in EFT training.
I agree to not record any part of this training in any format (audio, video, visual). Personal written notes of non-confidential material are permitted.
I agree to excuse myself from any video or live therapy sessions where I recognize any of the clients, and according to the ethics of my profession, will keep confidential the personal identifying information of case material shared in this training.
I agree to attend the training module in its entirety (48hrs).
Please list the location, instructor, and year of your Externship.
*
Hidden
Early Bird applies until:
Equity Rate Option
I identify as Black/African American.
I do not identify as Black/African American.
The Equity Rate registration option is for participants identifying as Black/African American.
Regular Rate:
*
Regular Rate: $1,700.00 USD
Equity Rate:
*
Equity Rate: $1,600.00 USD
Equity Rate: $1,500.00 USD
Equity Rate: $1,400.00 USD
Equity Rate: $1,300.00 USD
Equity Rate: $1,200.00 USD
Equity Rate: $1,100.00 USD
Equity Rate: $1,000.00 USD
Please choose the highest rate you can comfortably afford such that CFINE is able offer this Equity Rate to a greater number of participants.
Equity Rate (select a multiple of $25.00):
Price:
$25.00
Quantity:
Hidden
Agency/School:
Hidden
Additional Rate for CEs:
CEs $20.00 USD
No CEs $0.00 USD
Payment Method:
*
Credit Card or PayPal
How did you hear about this workshop?
*
CFINE Email
CFINE Website
ICEEFT Website
NEEFT Website
Word of Mouth
Other (please describe):
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Join our mailing list to learn about upcoming programs and discounts:
*
Yes, please!
No, thanks
Total:
$0.00
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