Adler 2 Day Intensive Registration Page March 2020 Adler 2 Day Intensive Registration Form First Name: * Last Name: * Email Address: * Phone Number: What type of mental health professional are you? * Registered PsychotherapistStudentPrivate PracticePsychologistAgency WorkSocial WorkerOther Payment Confirmation: * YES! I agree to pay the full workshop registration fee of $225.00 + HST via PayPal. NOTE: You will be redirected to PayPal.com to finalize your payment after you click the "Submit" button below. reCAPTCHA Submit Δ
