Get Registration Form (adobe Pdf) - University Of Pennsylvania School ... - Med Upenn

Filling out the Registration Form for the Intensive Four-Day Workshop in Exposure and Response Prevention for Obsessive-Compulsive Disorder is a straightforward process. This guide will walk you through each section of the form, ensuring you provide all necessary information accurately and efficiently.

Follow the steps to complete the registration form online.

1. Press the ‘Get Form’ button to access the Registration Form and open it in the appropriate editor.
2. Begin by entering your last name in the designated field, followed by your first name to ensure proper identification.
3. Fill in the work agency name where you are currently employed to provide context about your professional background.
4. Indicate your profession to help the organizers understand the diverse backgrounds of participants.
5. If you hold a license, input your license number; if unlicensed, please provide the name of your licensed supervisor.
6. Complete your work address section by entering the street address, city, and work phone number, including extension if applicable.
7. Fill in your home address with the city, state, and zip code to enable effective communication and mailing.
8. Provide your email address, ensuring it is an active account for correspondence, as this will be critical for workshop notifications.
9. Briefly describe your prior treatment experience in the designated box, offering insight into your background.
10. Choose your form of payment by indicating either check or credit card. If choosing check, note the payment instructions. If using credit card, you will need to contact CTSA directly for processing.
11. For credit card payments, fill in the cardholder's name, card number, and expiration date to complete the transaction.
12. Review all entered information carefully to confirm its accuracy before final submission.
13. Once satisfied, save your changes. You can then download, print, or share the completed form as necessary.

Complete your registration form online today to secure your place in the workshop.