Register for January 2025 Class Registering For January 2025 Class Step 1 of 2 – Choose Your Seminar(s) 50% For the Introductory Training, please select the full fee or reduced fee option below (reduced fee with case commitment only for attendees in Orange, Osceola, Seminole, Lake and Brevard counties). CLE for lawyers and CE for psychologist FPA members is covered in the registration fee. Non-FPA member psychologists and Florida Chapter 491 mental health professionals may obtain CE credit with an additional fee. When you register online, you can pay via PayPal with a major credit card or draft from a bank account. A PayPal account is not required. Please note: Only the word “PayPal” may appear on your statement so please make a note of this charge. If you would prefer to register by fax or mail, please print the form located here. For the Advanced Training, CLE for lawyers is included in the registration fee. Please only select the reduced fee if you have attended and completed our Introductory training. If you have any questions you may call (407) 862-2722 week days from 9:00 am to 4:00 pm.Introductory Training in the Interdisciplinary Team Model Of Collaborative Practice Quantity Price: $495.00 Quantity Above please enter the number of people you are registering. Date: January 9, 10 & 16, 17, 2025 Time: See agenda for start and end times for each day Location: VirtualFor Reduced Fee of $450.00 I attest that I meet the residency and license requirements for this reduced fee. I understand that by paying this reduced fee I have committed to completing 1 Collaborative Case at the Barry School of Law Pro Bono Collaborative Clinic for which I will receive no professional fees. Also, if I require mental health CEs for this training, I am responsible for an additional $25.00 fee. Introductory Training in the Interdisciplinary Team Model Of Collaborative Practice — Reduced Fee Quantity Price: $450.00 Quantity Date: January 9, 10 & 16, 17, 2025 Time: See agenda for start and end times for each day Location: VirtualRefresher Course Fee of $275.00 I attest that I previously completed this Introductory Interdisciplinary Collaborative Law Training with Roadmaps for Resolution trainers and would like to attend the same training again for the Refresher Fee of $275.00. Introductory Training in the Interdisciplinary Team Model Of Collaborative Practice — Refresher Fee Quantity Price: $275.00 Quantity Date: January 9, 10 & 16, 17, 2025 Time: See agenda for start and end times for each day Location: VirtualContinuing Education Fee for Introductory Training only (LMHC, LMFT, LCSW, non-FPA member psychologists) Yes, $25.00 No, $0.00 Total Cost: $0.00 Name* First Last If registering for someone else, please provide the name of the attendee here: First Last Attendee's ProfessionIf registering more than one person on this form, please add all additional registrants information in the comments section below. Thank you.Mailing Address: Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Phone:How did you hear about our training?Comments About Your Registration:If you have a PayPal account, your browser may automatically connect to your account. This is a default in the user’s PayPal account settings, for instructions on how to change this setting in your PayPal account, click here. Δ Payment accepted by PayPal, debit or credit card through PayPal processing system but you do not need a PayPal account.
