Step #1 - Please Fill Out the Registration Form Completely!
The requested information on this form is Not Used for Marketing Purposes!
- We must have this information in order to send you a confirmation letter with information on the location of the hotel with directions or in case of any changes after the mailing.
- When we receive checks and credit card payments from PayPal, we use the form information to connect your registration and payments, saving your spot in the Workshop.
- Without the form information we can not confirm your registration or reserve your seat.
- Cancellation Policy for all Workshops: If you decide to cancel, you must do so 21 days prior to workshop to receive a refund less a $50 administrative fee.
- If you have any questions, please Contact Walt Ciecko, (302) 429-0195
Please Begin Your Registration by filling out the form below first:
Step #2 - Select A Payment Method
Payment Method #1: Submit Your Payment by Check to:
- Complete and Send Registration Form Above First if You Have Not Done So as Yet.
- Mail Your Payment Check to:
Walt Ciecko, Ph.D, BCB
1301 North Harrison Street Suite 101
Wilmington, DE 19806
Payment Method #2: Payment by Credit Card:
- Complete and send your registration form above first before you complete your payment below.
- Click the PayPal Image below to make your payment using a credit card.
If you selected payment by credit card then click the PayPal Image to
Make Your Payment with a Credit Card at PayPal
This completes your registration process. Thank your for your registration. I look forward to working with you at the workshop. If there are any questions or concerns feel free to call me.
