Tazwood Mental Health Center

Conflict Resolution Skills for Supervisors           

Workshop Date: Friday, September 12, 2008

Name                  
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Organization
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Address
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City                                 State                    Zip Code
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Phone                                                  Fax
 
Please indicate if CEU’s are needed. __________
Certification Number:  __________________
 
Payment, Refund and No Show Policy:
· Payment or proof of check requisition due at time of registration.  No space will be held without this.
· There is a $10 cancellation fee after registration deadline.  There will be no refunds after the start of the training.
· All registrants are required to pay for the space they have reserved even if they do not attend the training.
 
MY SIGNATURE INDICATES UNDERSTANDING OF THE PAYMENT POLICY.
Registration must be signed.

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Signature                                                              Date

Make checks payable to:
Tazwood Mental Health Center
 
Mail registration to:
Tazwood Mental Health Center
Attn: Teresa Stalker
3248 Vandever Avenue
Pekin, IL 61554