'The AEDP for Couples Method' with David Mars & Diana Fosha
Day 1:
Transforming Trauma and Disconnection into the Felt Experience of Love
Day 2: Advanced Workshop on the Community Healing of a Couple's Trauma
Weekend of November 15th & 16th, 2014. 10am to 6pm.
Seton Hall University, South Orange, New Jersey

• A delicous hot lunch will be provided on campus and is included in the workshop fee. Lunch hours on Day 1 and Day 2 will provide opportunities for round table discussions with David Mars, Diana Fosha, Karen Pando-Mars, Ben Beitin, Angela Decandia and the four Assistants.
• Note: This workshop will be videotaped for producing professional training material. Designated seats will be provided for those who do not want to be videotaped.

Registration Forms for Two Days of Training [Return to Information Page]

Registration Form for Individuals

Early Bird Registration before October 15th receives up to $40 off

2 Days:
Licensed Professional $349
Intern/Trainee $249

Early Bird (before October 15th):
Licensed Professional $309
Intern/Trainee $219

AEDP Institute Members receive additional 10% discount
12 CEs available for the 2 day training for $20
Continuing Education is co-sponsored by R Cassidy Seminars

TWO WAYS TO PAY AFTER COMPLETING THIS FORM
1). Pay Securely Online Now with Credit/Debit Card or Paypal


2). Pay by Check or Money Order by Mail

Please do not use these characters % : <> + in this form

FULL NAME
(No qualifications here)

QUALIFICATIONS
(MA, PhD, MFT, LCSW)


EMAIL


PHONE (Cell)


FULL MAILING ADDRESS

PAYMENTS : EARLY BIRD PRICES
Choose One:
NON AEDP INSTITUTE MEMBERS
1.   Professional • $309
2.   Professional plus CEs • $329
3.   Student/Intern • $219
AEDP INSTITUTE MEMBERS ONLY (10% discount)
4.   Member Professional • $278
5.   Member Professional plus CEs • $298
6.   Member Student/Intern $197

Give name for recipient of any CE certificate

License #

METHOD OF PAYMENT:
Choose One:
  Online Now
  Check by Mail

ADDITIONAL INFORMATION
(If you have special needs let us know here)

List AEDP, EFT, SE or other experiential training (if any)

How did you hear of this workshop?

FORM SECURITY:
Delete all words in this orange box and type your first name


Click below to Send Your Booking
You will receive a copy by email
Details of how to pay on the next page



CANCELLATION POLICY:

If you need to cancel before November 1st you will receive a full refund less a $30 service fee. There will be no refund for registrations cancelled with less than 2 weeks notice.


Registration Form for Groups (3 or more)

Early Bird Registration before October 15th receives $40 off
2 Days in a group registration:
Licensed Professional $319
Early Bird per person:
Licensed Professional $279
12 CEs per person available for the 2 day training for $20
Continuing Education is co-sponsored by R Cassidy Seminars

TWO WAYS TO PAY AFTER COMPLETING THIS FORM
1). Pay Securely Online Now with Credit/Debit Card or Paypal


2). Pay by Check or Money Order by Mail

Please do not use these characters % : <> + in this form

FULL NAME (Primary Contact)
(No qualifications here)

QUALIFICATIONS
(MA, PhD, MFT, LCSW)


EMAIL (Primary Contact)


PHONE (Cell) (Primary Contact)


FULL MAILING ADDRESS (Primary Contact)


NAMES OF PEOPLE IN THIS GROUP REGISTRATION (3 or more)
(Include the primary contact's name here)


NUMBER OF PEOPLE IN THIS GROUP



TOTAL COST AT $279 PER PERSON
$ 

NAMES OF PEOPLE REQUIRING CEs


NUMBER OF CEs REQUIRED


TOTAL COST OF CEs AT $20 PER PERSON
$ 

PAYMENTS : EARLY BIRD PRICES
Please enter TOTAL PAYMENT at $279 per person attending plus $20 each for CEs required
NUMBERS ONLY
(Example for 6 registrants with 6 CEs - enter 1794 )
$ 

METHOD OF PAYMENT:
Choose One:
  Online Now
  Check by Mail

ADDITIONAL INFORMATION
(If you have special needs let us know here)

List AEDP, EFT, SE or other experiential training of registrants

How did you hear of this workshop?

FORM SECURITY:
Delete all words in this orange box and type your first name


Click below to Send Your Booking
You will receive a copy by email
Details of how to pay on the next page



CANCELLATION POLICY:

If you need to cancel before November 1st you will receive a full refund less a $30 service fee. There will be no refund for registrations cancelled with less than 2 weeks notice.



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