WMC's 1-Day DBT Made Simple Registration Form
Fill out the form fully for registration
Name
*
First Name
Middle Name
Last Name
E-mail
*
example@example.com
What organization are you a part of?
*
Mailing Address (we'd like to send you a personalized thank you from WMC!)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Would you like to hear more about offers from WMC in the future?
*
yes
no
Where did you hear about us?
*
Please Select
Linkdin
Instagram
Facebook
other
Venmo or Zelle Username *Please note that you will not be charged until after the workshop. Price to be charged will be $200. CEU's are an additional $50. (This webinar can be paid for by credit card, just as Lexi and we will send over the Auth form!
*
Submit
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