Please print and send the following registration form along with your check (payable to Maryland Center for EFT) to:

Maryland Center for EFT
c/o Douglas Tilley, LCSW-C
716 Giddings Avenue, Suite 33
Annapolis, Maryland 21401

Within two weeks of receipt of this form, you will receive confirmation, directions and additional information about the event. 

Registration Form:  I would like to register for the following training event(s):   ____   Core Skills Training - 4 Weekends             Place:  716 Giddings Ave. Ste. 33, Annapolis, MD             Prerequisites: This course requires that you have take the                                          Four day Externship in EFT                                          Place and date of completed Externship:                                                          _________________________________                     Mark the Core Skills weekends you wish to attend ____    All - I will attend all four  weekends -            Enclose $375 as payment for 1st weekend  The fee for the first weekend is due upon registration and the fee for each additional weekend is due at (or before) the previous training weekend.                If you wish to attend only selected weekends please check the boxes below and send in this form without payment.  You will be notified by September 1st about the availability of space and can make payment then.  ____    October 3-4, 2008  ____    December 5-6, 2008   ____    January 23-24, 2009  ____    April 3-4, 2009  ____    Externship in EFT  - March 2009               Registration begins September 2008             ____   EFT Group Supervision  -  September 2008 - April 2009              8 Friday mornings  10:00 - 12:00              Place:  716 Giddings Ave. Ste. 33, Annapolis, MD              cost: $400 - $200 with registration  $200 by 12-01-08 Your Name   ______________________________________ Degree, License  __________________________________ Address  _________________________________________                  _________________________________________                  _________________________________________ Home Phone     ___________________________________ Work Phone       ___________________________________ Cell Phone         ___________________________________ E-mail                ____________________________________

 

 

 

 

 

 

 

 

 

 

 

For Additional Information:

Call: Douglas Tilley at 410 268-4072

Email: doug@marylandcenterforeft.com 

Write: Maryland Center for EFT
c/o Douglas Tilley, LCSW-C
716 Giddings Avenue, Suite 33
Annapolis, Maryland 21401