Printable Seminar Registration Form

Seminar
Self Regulation Therapy® Practioner Training Advanced Level

The Fine Print
By submitting an application you are making a commitment to attend all classes at the Advanced Level. A course deposit of $725 is due upon acceptance into the training. The next tuition payment of $1450 must be submitted 30 days prior to the Advanced I training weekend. The final tuition payment of $725 is due 30 days prior to the Advanced II training weekend. A late fee of $100 will be levied on payments received after the tuition deadline.

Tuition is non-refundable if withdrawal is within 30 days of the course start date. If withdrawal is 31-60 days before course start date, a full tuition refund less $350 will be issued. If cancellation occurs outside of 60 days, a full tuition refund will be issued less a $75 administration fee.

Advanced Level classes may only be taken after successful completion of the entire Foundation Level training. A certificate of completion will be issued once students finish all requirements.

Ten SRT training sessions with a qualified SRT practioner as well as ten group supervision sessions are required for completion of the Advanced Level training; the costs are in addition to tuition fees.

Registration Form
Name:
Address:









City:
Postal/Zip Code:
Country:
Phone:
 W: H: C:
Fax:
Profession:
Email Address:

Date of first
Advanced Class:
City of
Advanced Class:
 
Tuition Payment Schedule
$2900 Total SRT tuition ($725 per weekend) to be paid as follows: $725 registration deposit with second payment of $1450 due 30 days prior to first class and balance of $725 due 30 days prior to second weekend.
 
Payment method: Visa ______   Mastercard ______   Cheque # ______
Please make cheques payable to the CFTRE and provide two post-dated cheques; one for the second payment ($1450) dated 30 days prior to the first class and the other for the balance ($725) dated 30 days prior to the second class.
Credit Card #:
Expiration Date:
Name on Card:
Signature:
 
Billing
If accepted into this training, I agree to allow the credit card listed here to be charged for all tuition, when that tuition becomes due.
Signed _____________________________________________________________________
 

Requirements
Your log of 10 personal SRT training sessions, 6 group supervisions, and the take-home assignment "Show What You Know" should be submitted with the registration form.

CFTRE Mailing Address
Canadian Foundation for Trauma Research & Education, Inc.
1488 West Hastings St
Vancouver, BC
V6G 3J6

CFTRE Fax Number
1-604-694-0086

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