Register Now! – EMDR TRAINING ASSOCIATES

Registration is a 2-step process.

Step 1. Complete and Submit Registration Request Form (below)

Please follow the formats given in the examples below each field,
Please DO NOT use the # sign anywhere in your information, and
Please use ALL-CAPS only where indicated.

LASTname *

FIRSTname *

Professional Designation *

e.g, RCC, RSW, RPsych, etc.--Please NO punctuation.

Registration / Licence Number *

e.g., 10044, 1044, etc.

Mailing Address *

PLEASE SPELL-OUT FULLY: e.g., 123-4560 North Burnaby Street; and please DO NOT use the number sign [#] and NO punctuation.

City *

Please spell-out fully--do not abbreviate.

Province/State *

Please use 2-letter abbreviation: e.g., AB, BC, WA, etc.

Postal / Zip Code *

e.g., V5A 1S6, etc.

Country *

e.g., Canada, USA, etc.

Phone *

Email *

Confirm Email

*IMPORTANT* for those with YAHOO or YMAIL email addresses: After you have completed this form and clicked SUBMIT (below), please contact the registrar to confirm that your registration request has been received ( amarica@shaw.ca ).

Highest Mental Health Degree *

e.g., MA, MD, MEd, MScN, MSW, MCP, PhD--Please NO punctuation.

Field of Study *

Your mental health field: e.g., Counselling Psyc, Social Work, Clinical Psyc, etc.--if meaning is apparent, you may abbreviate, but NO punctuation please.

Issuing Institution *

e.g., SFU, UBC, UofT, UofA, etc.--Please NO punctuation.

Regulatory Body *

e.g., BCACC, BCCSW, CPBC, etc.--Please NO punctuation.

Are you covered by professional liability insurance? *

PRESSING SUBMIT notifies us of your intention to take the course.

Step 2. Pay the $100 Deposit Fee

Once your registration has been approved by the registrar, you will be sent an email with instructions for payment of deposit and fees.
The $100 deposit fee is required to secure your place in the training. This deposit is part of the course fees. For more about fees, see the Fees & Cancellations page.

Registrar

Alivia Maric, PhD, RPsych
Telephone: 604-251-7275
Email: amarica@shaw.ca