Complete all information fields. Use [ NA ] if not applicable.
Submit this form online to register.
Send the form to your printer and print two copies.
To confirm your registration :
Send one copy with your registration check or international postal money order
in U.S. Funds payable to COUNSELSOURCE.
(Note: Your admission to the workshop will not be confirmed until
your registration deposit funds are received.)
Save one copy for your records.
Note: Registration deposit of $35.00 per workshop is nonrefundable.
Registration and workshop materials with location map will be sent
when full payment is received.
Full payment must be received 21 days prior to workshop date to
be eligible for discount or group rates.
Written cancellation must be received in our office 14 days prior
to workshop date to receive refund (less registration deposit).
If this direct form does not function for any reason
Please immediately notify us via our direct email at counslor@yahoo.com
Send completed form and deposit to:
COUNSELSOURCE TJTA Workshop P.O. Box 64421 Virginia Beach, VA 23467-4421 United States
