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April 2019 Application - RISHI's Tending the Flame/Resiliency Curriculum Training Workshop

April 2019 Application - RISHI's Tending the Flame/Resiliency Curriculum Training Workshop

1. Name and Education History *This question is required.
3. Professional Institution or Affiliation *This question is required.
Professional Position (if more than one held concurrently)
4. Work Contact Information *This question is required.
5. Copy of Work Contact Information *This question is required.
6. Home Contact Information
7. Which is your preferred email? *This question is required.
8. Name of institution where you will teach the RISHI Resiliency Curriculum *This question is required.
11. Please provide the contact information of your institution's administrator/department chair for supporting and approving the use of the curriculum and understanding of the licensing fee requirement. *This question is required.
CME credit for this workshop training will be forthcoming.
CANCELLATION & REFUND POLICY: A deposit of $300 is due at time that your application is accepted. The balance is due by March 26, 2019. A full refund of deposit (less processing fee of $25) will be issued for cancellations on or BEFORE April 1. Cancellations after April 1 will forfeit deposit.