Registration Form
Name:
Degree
License Number:
Address:
City, State, Zip
Telephone
Email Address

Please select all workshops you will be attending.

March 7: Chemical Dependency Licensure & Ethics for Mental Health Professionals

Aug 22: Legal and Ethical Aspects of Practice for Psychologists

Practicing Telepsychology in Ohio

If you choose to become a member please choose the member rates.

 

 

Comments:

 

Your card will be charged $

 

 


SSL