If selected "Other" for Discipline, please put "N/A" for License Number below. Format: 000.000000
If you selected Credit Card, we will contact you via email within 5 business days to submit payment.
If you selected Check, please ensure the check is mailed at least 10 business days prior to the course date.
We are unable to hold spots for courses until payment information is received.
Please prove you are human.
© Quality Therapy & Consultation 2014.