Course Order Form

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Course Order Form

Seminars 2000
Attention: Lyndsey Herrman

8511 SW 51st St.
Topeka, KS 66610

Phone: (785) 845-8455
Fax: (785) 478-0181

*Please fill out registration form on-line and then print it out and Fax it or mail it with your check* Pre-registration is required.
Your E-mail:
Profession:
First Name:
Last Name:
Organization Name:
Work Phone number:		- -
Home Phone number:		- -
Mail Address:
City:
State:
Postal Code:		-

Select Desired Courses:
Diagnosing and Treatment Family Diagnosis [6 CE/$69.00] Boys Town PEM Diagnosing Model [10 CE/$99.00] Treating Youth with DSM-IV Disorders [6 CE/$69.00] Childhood and Adolescent Clinical Psychopharmacology [6 CE/$69.00] Ethics Family Ethical Challenges [3 CE/$49.00] Ethical Considerations of Blended Families [3 CE/$49.00] Thorns of Love: Spousal Abuse/Alcohol Ethics [3 CE/$49.00] Who Draws the Line? [3 CE/$49.00] Childhood and Family Dangerous Kids (available June)[7 CE/$79.00] Ten Things Every Child With Autism Wishes [8 CE/$89.00] Bridges Out of Poverty [15 CE/$159.00] 10 Simple Solutions to Panic [8 CE/$89.00] The Attachment Connection [13 CE/$139.00] The ABC's of Discipline [8 CE/$89.00]
Enclosed is my check payable to Seminars2000 for $
Please Charge My Credit Card $
Visa Mastercard Credit Card Number: _________ - _________ - _________ - _________ Expiration Date: _________________
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