Register Online by completing the form below.

When you click on submit it will take you to a page that will allow you to pay by PayPal.

You do not need a PayPal account to pay by Pay Pal. It allows you to simply use your credit card.

You will be asked to enter the amount of your payment. The fees are listed on the previous information page. Be sure to know the amount of the workshop before you proceed to the payment page.

If you prefer to pay by check, please print the form below, and mail with your check to:

                    Live Oak Center for Psychotherapy and Education
                    5011 Golden Foothill Parkway, Suite 6
                    El Dorado Hills, CA 95726

                    Make checks payable to Live Oak Center
 

Name and Date of Workshop :

Name of Registrant:

License Type :

License Number :

Address:

City:

State:

Zip Code :

Daytime Phone:

Evening Phone:

E-Mail:

May we email you about upcoming events?

Are you able to climb a flight of stairs?

Comments:

You will receive an email confirmation.

For more information, call Alisa Holleron at 916-933-5011 ext. 0.