March 20 Registration Form | Expressions Speech

March 20, 2021

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CYCLES FOR PHONOLOGY

Practical, Use-The-Next Day Continuing Education for SLPs

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Registration Form

First Name

Last Name

Email Address

Phone

Address

YOUR time zone

I understand that this live Seminar will be presented at 9:00 AM EST (New York, USA). I am responsible for knowing the time the seminar will begin for MY time zone. For CEUs to be awarded, I understand that I must attend the ENTIRE seminar. No partial credit will be given.

Your Initials

I have an active ASHA CE Registry

Yes

ASHA ID #

Notice of Recording of Seminar
This seminar will be recorded and viewable for future purchase by others for CEUs on our seminar site at . It is highly likely that your Zoom camera image and name will be viewable in this recording.

If you do not wish to be a part of the recording, please do not register for the LIVE seminar. Instead, you can watch a pre-recorded (not live) version of the same seminar. Email to be directed how to do this.

Please sign below that you acknowledge what has been disclosed above.

Your Signature

You will checkout via PayPal.

But you do not need a PayPal account. You can pay with a debit/credit card as a guest.

Thanks for submitting!

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Expressions Speech, Language, & Myofunctional Center

March 20, 2021

CYCLES FOR PHONOLOGY