Registration Form Thank you for your interest in "Conducting Effective and Adherent Individual DBT Sessions" workshop! This workshop runs from Wednesday, October 23 – Friday, October 25, 2024 from 9 AM – 4:30 PM PST (11 AM – 6:30 PM CST / 12 PM – 7:30 PM EST on all three days) via Zoom. Recordings of this workshop will not be available. Ready to register and pay? Fill in the form below. You will be redirected to PayPal to pay and complete registration. You do not need a PayPal account to pay! Need more information? Visit www.dbtvancouver.com/our-events. Are you part of a group? Groups of 3 or more are eligible for a 10% discount. Groups of 5 or more are eligible for a 15% discount. Email info@dbtvancouver.com for more information and to get a discount code. Group discounts must be organized before registration, i.e., can not be made retroactively. Students are not eligible for group discounts. Questions? Email info@dbtvancouver.com or call Jen (DBTCV office manager) at 604-569-1156 during regular business hours.RM_StatsParticipant InformationFirst name *Last name *At the end of the workshop, participants will receive a letter of attendance confirming the number of credits awarded. Please indicate below how you would like your name to be listed on the letter.Name on letter of attendanceEmail *Enter email again *The receipt and CE letter will go to this email address.Phone Number *PronounsCity of residenceProvince/StateCountry (if outside of Canada or US)OrganizationProfessional Background * Current grad student (Masters / Doctorate) Nurse Occupational Therapist Case Manager Registered Clinical Counsellor Registered Psychotherapist Registered Social Worker Doctoral clinician (working towards registration) Registered / Clinical Psychologist Psychiatrist / MD Other (please enter)Please check all that applyProfessional Practice I work in a community mental health team. I work in a hospital. I work as a solo practice. I work in a group practice. Other (add your own)Do you have any previous DBT training? * I’ve done some self-study. This is my first formal DBT workshop. I’ve completed some formal DBT training already. I’ve observed some DBT groups. OtherClick all that apply.How did you hear of this workshop? * Friend / Colleague School Google/ web search BC Psychological Association I am on your email list OtherIs there anything you would like us to know? PaymentEarly Bird registration (May 23 – September 25, 2024) Early bird professional: $745 + $37.75 (GST) = $782.75 Early bird student: $595 + $29.75 (GST) = $624.75Regular Registration (September 26 – October 21, 2024) Professional: $830 + $41.50 (GST) = $871.50 Student: $650 + $32.50 (GST) = $682.50 Cancellation policy * I understand DBTCV will provide a refund (minus $75 administrative fee) up to 14 days prior to the start of the workshop. Refunds will not be provided after October 9, 2024. Recordings * I understand recordings of this workshop will not be available. Select your type of registrationSelect an optionProfessional (October Individual - Early Bird) ($ 745)Student (October Individual - Early Bird) ($ 595)After you click Submit, you will be redirected to the PayPal website to complete your payment for this workshop. An email confirmation will be also be sent to the email address you provided. Please be sure to check your junk / spam folder! Don't have a PayPal account? Not to worry! You can still use a debit or credit cart to complete purchase.Notes for AdminSelect a payment method * Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
