Support Group Registration
RPC Support Group Session are Free of Charge and you can attend the sessions as many times as you want; however, there is a token $40 registration fee (one-time as a form of donation for our services) - questions please email Rogerian Psychology Centre: clientcare@rogerianpsychology.com or WhatsApp +65 86284685.
Name:
*
First Name
Last Name
Highest Qualification
*
Occupation
*
Company (if any)
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
*
example@example.com
Phone Number
*
Please indicate your preferred days and time slots for the support group sessions.
*
Please indicate the reason that you would like to sign up for our support group?
*
Please indicate the concerns that you would like to have supported through our support group sessions.
*
Support group registration fee (one-time, non-refundable)
*
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Registration Fee (non refundable)
$
40.00
SGD
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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