AAMFT Summer Institutes for
Advanced Clinical Training
August 10-14, 2008
 Vancouver, Washington
Online Registration Form

Instructions: Please use your tab key or mouse to move from box to box.  Do not use the enter key.  All fields in red require an entry.  

ID Code

First name
Last name
AAMFT ID#
  Please Enter Your Mailing Address
Street Address
City
State/Province
Zip/Postal Code
Country
  Please Enter Your Credit Card Billing Address
Please check here if your credit card billing address is the same as your mailing address. 

Please check here if your credit card bill address is different than your mailing address.  (If this box is checked, please fill out information below.)
Billing Address Street Number
Billing Address
Zipcode
   
Contact Phone #
Fax#
Home#
E-mail
   
Promotional Code

How Did You First Hear About The Summer Institutes (Please Choose One)

Status: (Please select one of these options.  If you are ONLY attending the Refresher Course, please choose the last option)
 

Courses: Please select your 1st and 2nd course preferences.

The Approved Supervisor Refresher Course  (Please Choose One)

Welcome Reception (Please Choose One)
Free Event, Sunday, August 10 at 7:00 p.m.

Closing Reception (Please Choose One)
 Free Event, Wednesday, August 13 at 6:00 p.m.

Please check here if under the Americans with Disabilities Act (ADA),
you require auxiliary aids or services.

Specify special assistance required:

Select Your Method of Payment (all payments must be in U.S. dollars)

Credit Card Information

Credit Card Number
Exp. Date
V Code (The V Code is the number located on the back of your credit card, after your credit card number)
   
Cardholder 

Please review your selections before you submit.  This registration form does not guarantee your workshop selections.  You will receive your official confirmation from AAMFT in the e-mail.  

Cancellation Policy
Requests for refunds must be made in writing and postmarked by July 18, 2008.  All refund requests for the Summer Institutes are subject to a $100 cancellation fee. All refund requests for the Approved Supervisor Refresher Course are subject to a $25 cancellation fee.  There will be no refunds after July 18, 2008.  Cancellations not received in writing by July 18, 2008 will not be eligible for a refund.  No-shows will not be refunded.  In case of circumstances beyond its control, the AAMFT reserves the right to make necessary changes in presenters and content of the Summer Institutes and Approved Supervisor Refresher Course without notice.

I understand that by clicking the "Submit your information to AAMFT" button below, I am authorizing AAMFT to charge the above credit card for the amount listed below and that I understand the cancellation policy.

Your Total Registration Cost is:

If your Total Cost is blank then please go up to the box marked status and make a selection.

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