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Please send us an email with the following information:
Application for BMP workshop/training (date)__________ (location) ________________________
Name_________________________________________________________________________
Address_______________________________________________________________________
Phones (work)____________(home)____________ (cell)________________________________
Email__________________________________________
Occupation (Please include pertinent background in any helping professions including licenses, certificates, and registry. Have you ever had any professional grievances filed against you? If so, please add a full explanation and history of the resolution?)
Statement of interest in this workshop/training.
Professional References (please include address, phone numbers, and email)
A deposit (generally $100) is required for most events and is nonrefundable if accepted.
BMP training is a commitment. If accepted into this workshop or training, I agree to attend all classes and participate fully in a professional fashion. This includes giving feedback directly and in a timely fashion. I agree to the specified payment plan and understand that full payment is required regardless of attendance.
Student’s signature ____________________________________________________ Date_________
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