Workshop Registration 

 
Registration Form

An Introduction to Radically Open DBT (RO-DBT)
Date: Jan 19, 2018

  Location Minnesota: cost: $200/-
   Location Minnesota: (student or group Discount): cost: $175/-

* Discount available to Students with Valid Student Id or groups of 5 or more from an agency. Only 1 discount per person

     Note: Credit Card payments accepted through PayPal.

Participant's Name*
Participant's E-mail*
Participant's Phone*
Payee's Name*
Payee's Email*
Payee's Phone*
Address*
City*
State*  Zip 
Agency

 

Registration will not be "confirmed" until payment is received or arrangements have been made for payment. When payment is received, a confirmation, containing instructions and directions, will be sent to the email address mentioned above.

Please click on the Submit Registration to process your registration.
We will send you a confirmation when we receive your fees.

*: Mandatory fields