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Workshop Registration Form |
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Print Name: ____________________________________ Employer: ___________________________________________ Mailing Address: _____________________________________________________________________________________City: ________________________________________ State: ______________ Zip Code: _______________________ Work Phone: ( ) ______________ Fax: ( ) _______________ Email: __________________________________ |
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Select “CEU Opportunities” from the links at the bottom of this page for full workshop descriptions. The workshops below are co-sponsored by the North Carolina Psychological Association and the North Carolina Association for Behavior Analysis. The North Carolina Psychological Association is approved by the American Psychological Association to sponsor continuing education for psychologists. The North Carolina Psychological Association maintains responsibility for these workshops and their content. Each workshop is offered for 3 hours (6 hrs for Workshop I) of continuing education credit. BCBA CEUs (3 for all workshops except Workshop I) will also be available. The student workshop rate is available to students who can provide proof of current student status. |
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If you are not a current member and would like to be, please complete the membership form in addition to the information above. The membership registration below is for the period of January 1st through December 31st, 2008. |
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NCABA Membership Dues |
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Full Member (1 year) |
$15.00 |
$15.00 |
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Full Member (3 years) |
$40.00 |
$40.00 |
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Paraprofessional/Parent Member (1 year) |
$10.00 |
$10.00 |
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Paraprofessional/Parent member (3 years) |
$25.00 |
$25.00 |
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Student Member (1 year) |
$10.00 |
$10.00 |
Mark (X) |
*Workshop Registration |
Postmarked on or before August 26th |
Postmarked after August 26th |
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Ethics Workshop I: (UNC-Wilmington) Fri. Sep 5th 9:00 AM |
$90.00 |
$130.00 |
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Ethics Workshop III: (Winston Salem) Fri. Sep. 12th 9:00 AM |
$55.00 |
$80.00 |
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FBA Workshop IV: (Winston Salem) Fri. Sep 12nth 1:30 PM |
$55.00 |
$80.00 |
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Two Workshops (indicate which two above) |
$90.00 |
$130.00 |
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*Student Workshop Rate (indicate which workshop above) |
$25.00 |
$30.00 |
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*Student Workshops Rate (indicate which two workshops above) |
$45.00 |
$50.00 |
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Make check payable to NCABA |
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Mail check and form to:Psychology ServicesNCABA Secretary/TreasurerMurdoch Developmental CenterPO Box 3000Butner, NC 27509 |
If you have any questions:call (919) 575-1261or email: help@nc-aba.com Fax: 919-575-1282 www.nc-aba.com |