Winter PTTI Seminar Registration Form
PLAY THERAPY TRAINING WINTER PROGRAM 2008 - 2009
Tuition: $200(U.S. Dollars) per one day seminar
Registration form must be accompanied by your deposit check of $100 per seminar.
Balance due on or before first day of the seminar.
Checks must be drawn on a U.S. Bank in U.S. Dollars made payable
to the Play Therapy Training Institute Inc., or charge to your __ VISA or
__ Mastercard. Expiration date, CVV code (the last 3 digits of the number that
appears in the signature box on the back of your card) and signature are required with credit card payment.
Print Name (as it appears on card) ________________________________________
Card Number _________________________Expiration Date ________ CVV __________ Amount of the charge $ _________
Signature (required for Credit Card Payment) _____________________________________
Mail To: Play Therapy Training Institute, Inc. P.O. Box 1435, Hightstown, NJ 08520
Name ______________________________
Address ________________________________________
_______________________________________________
Phone (Office) Area Code ( ) ___________ Phone (Home) Area Code (
) ___________
For further information about the Training Program, call or E-mail
(609) 448-2145, FAX (609) 448-1665 E-mail: ptti@mac.com
Please check the seminar(s) you wish to attend:
___Seminar-#101 ___Seminar-#102 ___Seminar-#103 ___Seminar-#105
___Seminar-#106 ___Seminar-#130 ___Seminar-#153 ___Seminar-#204 ___Seminar-#211
___Seminar-#217 ___Seminar-#230 ___Seminar-#231 ___Seminar-#233
___Seminar-#253 ___Seminar-#291 ___Seminar-#295 ___Seminar-#296