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Registration is a two-step process.  Fill out the form below.  After submitting the form, scroll down and choose one of the payment options below.  

EMDR Refresher 

Registration


January 27-28, 2022

10:00 am - 5:30 pm (eastern)


First Name*

Last Name*

Email Address*

Degree*

Professional License & Number

Phone

Address

Address Line 2

City

State/Province/Region

ZIP/ Postal Code

How did you hear about this training?*

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Additional Comments


EMDR Refresher Payment in Full

$425.00

EMDR Refresher Payment Plan

$475.00 ($275.00 deposit)

Check all the boxes below when choosing the payment plan option.

First & Last Name*

Email Address*

Payment Plan Consent Form*

EMDR Refresher Payment in Full for COCOA members

$400.00

EMDR Refresher Payment Plan for COCOA members

$450.00 ($250.00 deposit)

Check all the boxes below when choosing the payment plan option.

First & Last Name*

Email Address*

COCOA ID and Discount Code*

Payment Plan Consent Form*

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We live in a cynical world, a cynical world; and we work in a business of tough competitors.

Jerry Maguire, 1996

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