Completar este formulario de registro enviado con su pago a través de Paypal confirmará su lugar en el taller y / o iniciará las citas para la sesión de parejas. La tarifa del taller no es reembolsable una vez transcurrido el plazo de inscripción.

    Please choose one of following:


     

    If you have chosen Couples Counseling Sessions or Couples Counseling Sessions & Workshop, please select the days and times when you are both available:

    Mon
    Tue
    Wed
    Thu
    Fri
    Sat

     

    Partner #1: First Marriage
    YesNo

    Partner #1: Children
    YesNo

    Partner #1: Ethnicity-Check all that apply

    (Optional but helpful):

    Partner #2: First Marriage
    YesNo

    Partner #2: Children
    YesNo

    Partner #2: Ethnicity-Check all that apply

    (Optional but helpful):


     

    After clicking on the send button, please pre-pay for the workshop using the PayPal drop-down menu and pay button below. You may also pre-pay over the phone at 503-253-0964 or send payment to our office at 8383 NE Sandy Blvd, Suite 205 in Portland. After receiving your registration and payment, we will be in contact with you.
    Thank you!