Name: 2022.1.24, 25 and 27.DC 0-5 Training.Barron, Dayton, Wheeler
SKU: 65948
Availability: InStock

Name*

First Last

Email (enter carefully - this is where notifications and confirmations will be sent for each registered participant)*

Agency/Organization*

Address*

Street Address Address Line 2 City State ZIP Code

Agency Address

Cell Phone (would be used only for emergencies)*

What is your category of endorsement, if applicable?*

Please indicate your discipline*

Please indicate your primary practice setting*

How many years have you been a supervisor/independent reflective consultant?*

What are you most looking forward to getting out of this training? What questions do you have for the presenters?

Base Price

I am registering as a MI-AIMH Member ($100) | Non-Member ($130):*

Membership ID*

Are you a Licensed Social Worker or Licensed Professional Counselor?*

License Number (required for continuing education)*

Total

$0.00

2022.1.24, 25 and 27.DC 0-5 Training.Barron, Dayton, Wheeler

Product Description