| Workshops |
Managing Bipolar Disorder Students
Friday 30 November, 2007
Early Late
Cost: Single Registrant $100 $110 Per Person
Two or More** $ 90 $100 Per Person
College Students*** $ 45 $50 Per Person
6 hours continuing education credit
*Registration must be received seven days prior to the workshop date
**Price per person when two or more register at the same time from the
same school campus.
***Must submit a college ID with payment!
For additional information please leave a message below with your e-mail.
Friday 30 November, 2007
Early Late
Cost: Single Registrant $100 $110 Per Person
Two or More** $ 90 $100 Per Person
College Students*** $ 45 $50 Per Person
6 hours continuing education credit
*Registration must be received seven days prior to the workshop date
**Price per person when two or more register at the same time from the
same school campus.
***Must submit a college ID with payment!
For additional information please leave a message below with your e-mail.
| Send Checks or Purchase Order to: CPC 106 Denton Tap Rd., Ste 210-216 Coppell, Texas 75019 Only Checks and Purchase Orders are accepted. P.O.'s may be faxed to: 972-304-0400 |
Managing Bipolar Disorder Students
Print this page from your web browser to obtain a registration form!
Comfort Inn DFW North Irving, TX Friday 30 November, 2007
(972) 929-5757 or Toll Free Number: 1-800-4-CHOICE
_____________________________ _____________________________
Registrant's Name Registrant's Name
_____________________________ _____________________________
Registrant's Name Registrant's Name
Total Cost: ____________
Method of Payment Accepted
Check or Money Order
Purchase Order #:______________________________
Credit Card: Must have the credit card number with expiration date, the three letter code on
the back of your card, your name as shown on your card and your billing address.
Credit Card Type: ______ Number__________________Code:______Expiration Date:_____
Name as shown on card:_____________________________
Mailing Address:_____________________________________________________________
City State Zip
Phone Number:________________________________
E-Mail:_______________________________________
Signature:________________________________
NOTE: If you prefer you may call and give us your credit card information. 972-506-7111
Mail this form with Payment or PO to:
CPC
106 N. Denton Tap Rd., Ste 210-216
Coppell, Texas 75019
Print this page from your web browser to obtain a registration form!
Comfort Inn DFW North Irving, TX Friday 30 November, 2007
(972) 929-5757 or Toll Free Number: 1-800-4-CHOICE
_____________________________ _____________________________
Registrant's Name Registrant's Name
_____________________________ _____________________________
Registrant's Name Registrant's Name
Total Cost: ____________
Method of Payment Accepted
Check or Money Order
Purchase Order #:______________________________
Credit Card: Must have the credit card number with expiration date, the three letter code on
the back of your card, your name as shown on your card and your billing address.
Credit Card Type: ______ Number__________________Code:______Expiration Date:_____
Name as shown on card:_____________________________
Mailing Address:_____________________________________________________________
City State Zip
Phone Number:________________________________
E-Mail:_______________________________________
Signature:________________________________
NOTE: If you prefer you may call and give us your credit card information. 972-506-7111
Mail this form with Payment or PO to:
CPC
106 N. Denton Tap Rd., Ste 210-216
Coppell, Texas 75019
