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To register for an upcoming training, please complete the form below. If you encounter any problems with our form, please email the following info to Wendy@therapywithaTwist.com

Name (required)

Email (required)

Address

City, State, Zip

Contact Phone

Fax

To register for a training event, please select the training date you are interested in.

Payment Method
 PayPal Check

Fee-See Specific Training-can be paid by check or via paypal (pay pal fee as charged by pay pal). No Refunds.

To Register-Fee must be received by registration date unless otherwise arranged.

You must EMAIL information below AND MAIL a copy of the email with a check payable to Wendy Ludlow, LCSW -or- email the below information and request a pay pal invoice in your email. There is a moderate fee ($10) charged due to paypal fees. No mail required if you email form and pay by pay pal.

Email: Wendy@TherapyWithaTwist.com

Mailing address: Wendy Ludlow, P.O. box 132, Bronx, NY 10471

FAX: 718-601-1008 (YOU MUST ENSURE RECEIPT FOR THIS OPTION IN PARTICULAR DUE TO THE NATURE OF FAX COMMUNICATION ISSUES)

Email: ASAP to reserve your spot! Use email if possible. CONFIRM RECEIPT IF YOU DO NOT GET A REPLY WITHIN 24 HOURS.

Confirmations will be sent VIA EMAIL to ensure receipt! Please ensure you get confirmation!

Print Form Below for mail and fax

Registration Form

Email: Wendy@TherapyWithaTwist.com
Fax: 718-601-1008
Snail Mail: Wendy Ludlow, P.O. Box 132, Bronx NY 10471

Name:
Address:
Phone #:
Email:
Fax:

Cancellation Policy: no refunds given.

I am registering for the following:
Name of Training Date

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4.

Method of Payment:

_____Pay Pal invoice requested – I am aware of additional fee for this service. email to:__________________________.

____I will send a deposit or the full amount of the training to the P.O. Box listed. If a deposit is sent, I am aware that the remainder will be due on the date of the training



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