Registration for Training Courses, Seminars and Workshops

Registration Form for Seminars and Retreats

Printable Form

Please note which seminar you would like to attend.
As space is limited, please register early.

Seminars:
Workshop Title: (required)
Dates:
Name: (required)
Email: (required)
Address:
City:
Prov./State:
Postal/Zip Code:
Country:
Phone:
Work Phone:
Fax:
Occupation:
Education/Play Therapy Experience:

Have you taken a seminar with me before? If so what seminar have you taken?

What are some of the issues and goals you would like to address in the seminar that you have registered for?

Would you like to book individual consultation/personal/professional development time after the seminar? On what day? How many hours?

PLEASE NOTE: A $100.00 non-refundable deposit is required at the time of registration. The remaining amount is due one month prior to the seminar. Space in seminar will not be confirmed until deposit has been received for each individual seminar. Please make your cheque or money order payable to Marie-José Dhaese, and send it in by mail to:

Marie-José Dhaese
846 San Malo Crescent
Parksville, British Columbia,
V9P 1S5, CANADA

CANCELLATION POLICY: Cancellation must be received by telephone and in writing one month prior to the date of the seminar or the whole amount will be forfeited. Before that date, your $100.00 deposit is non-refundable and will be held for administrative fees.

Comments

Click the Submit button and don't forget to mail in your deposit.
Note: if you do not receive a reply in one day, please phone:
(250) 248-1290.

If you would like to mail in your registration,
please click HERE for a printable form.

CENTRE FOR EXPRESSIVE THERAPY
Marie-José Dhaese Ph.D., RCC, ATR, RPT-S, CPT-S
Phone: (250) 248-1290

Email: mariejose@shaw.ca
846 San Malo Crescent
Parksville, British Columbia
V9P 1S5
CANADA