CEU Registration Form

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Policies for single date workshops

Registration due dates:
Early Registrations must be postmarked or paid by PayPal 30 days prior to the seminar.
Regular Registrations must be postmarked or paid by PayPal 10 days prior to the seminar.
For Late Registration, pay by PayPal, and send registration only through email or automated form below (not postal mail). No group or non-credit discounts with late registration.

Group discounts: Groups of 3 or more registering together receive a $5 discount per person (with all checks in the same envelope or a combined PayPal payment).

Non-credit discount: If you will not need CEU's or ANY proof of attendance, take a $5 discount.

Transgender combination discount: Register for any two Transgender seminars, and deduct $5 for the second seminar. (For series workshops, 3 classes count as one seminar.)

Cancellations: For a refund, minus $5 processing fee, cancel by phone no later than 7 days PRIOR to the seminar. There are no exceptions to this cancellation policy.

Policies for workshop series

For the Advanced Transgender Study Group, the fee structure is different. The cost is $170 with CEUs, or $150 without CEUs, for 3 consecutive classes. Cancellations must be made by phone at least 7 days before the first of the three classes you've registered for. No partial refunds.

For Transgender Night at the Movies, the fee structure is different. With CEUs, the cost is $50 each, or series discount of 3 workshops for $140, or 5 workshops for $230. Without CEUs, the cost is $20 each, or series discount of 3 workshops for $55, or 5 workshops for $90. Admissions fees are not refundable, but can be shared, and are good for any date within 6 months of purchase. Register for this series at https://www.FeministTherapyAssociates.com/TransFilms.html

Transgender combination discount: Register for any two Transgender seminars, and deduct $5 for the second seminar. (For series workshops, 3 classes count as one seminar.)

Questions? Call us at 510-527-5662.

CEU Registration Form

Complete this form and then make your payment via www.PayPal.com to BJCourtney@earthlink.net . Or mail payment to Jeanne Courtney, MFT, PO Box 453, El Cerrito, CA 94530. When registration and payment have both been received, your space will be reserved. The location address and directions will be sent to you via email the week of the seminar. Please feel free to call Jeanne at 510-527-5662 ext 2 with any questions.

(Use cursor or TAB key to move to the next field; hitting ENTER will submit the form.)

Name:
License Type:
License Number:
Agency (if applicable):
Address:
City:
Zip Code:
Phone(s):
Email:
Type email again:
Seminar Date:
Seminar Title:
Registration type:
Discounts (check all that apply)
		Group $5
		Non-credit $5
		Transgender Combination $5
Amount Paid:
How Paid:
How you heard about the seminar:
If Colleague or Other, please specify:
Medi-Cal seminar only - county panels you are on:
Medi-Cal seminar only - county panels you are interested in:
Medi-Cal seminar only - office location city(ies):


Advanced Transgender classes only - describe your training & experience:
Advanced Transgender classes only - do you have a case to present?