Application Form – Introductory Workshop

We will email you when we receive your application. The email will include details on submitting the $60 workshop fee.

Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Occupation

Professional License

License #

Date(Required)

Please make a selection - Required

June 22, 2024

Introductory Workshop - Full Tuition(Required)

Price:

Comments

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Faculty

Armin Baier
L.C.S.W., J.D.

Gary Yontef
Ph.D., A.B.P.P.

1800 Fairburn Ave
Suite 103
Los Angeles, CA 90025
email us