Application Form

Weekend Training Program:

To pay by check, please download the application form and mail with the check:  Or, complete the form below to pay via PayPal.

Name
Address
City, State, Zip
Phone
Email
Occupation
Clinical License

Weekend Training Program:
Full tuition: $1750.00*
Deposit only: $500.00*
Deposit: other amount*

* Any cancellation notice must be received one week in advance of the program starting date and an administration fee of $75 will apply. There are no refunds for missed weekends during the training year.

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