PSYCH-K® Health & Wellbeing Program
May 8-11.25, Long Beach, CA
Your details
*
First Name
Last Name
What name would you like on your nametag?
What title (e.g., MD, Dr., LMFT, PhD) would you like included on your affirmation of attendance? Fill in if applicable.
E-mail
*
example@example.com
Phone Number
*
Address
*
City
State/Country
Do you agree to be included in photos and/or videos during the workshop?
yes
no
Anything you would like to add
Choose appropriate option
*
prev
next
( X )
Full Tuition
Full tuition for the workshop
$
1,850.00
Quantity
1
2
3
4
5
6
7
8
9
10
Deposit To Hold Your Spot
This ticket will reserve your spot in the event. Outstanding balance must be paid 7 days prior to the workshop
$
925.00
Outstanding Balance
Pay 7 days prior to the workshop
$
925.00
Quantity
1
2
3
4
5
6
7
8
9
10
Repeater
If you already took this workshop and would like to refresh your knowledge, this ticket is for you! Bring your materials with you.
$
1,050.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
Submit
Should be Empty: