* = Required Information
*
First Name:
*
Last Name:
Title:
*
Employee of:
CHD
*
Program Name:
*
Supervisor Name:
Address:
City:
State:
Zip:
*
Phone:
Fax:
Email:
Professional Discipline:
License No:
*
CE's:
Yes
No
Not available for Beginning Clinical Series.
*
Desired Workshop:
(Hold down Ctrl button to select more than one workshop.)
Advanced Clinical Series: Self-Injurious Behavior in Adolescence:
Advanced Supervisory Series: Advanced Conflict Management:
Advanced Supervisory Series: Managing Difficult Employees: Discipline and Termination:
Advanced Supervisory Series: Supervising Former Peers:
Beginning Clinical Series: Adolescent Overview:
Beginning Clinical Series: Establishing Relationships:
