Schedule: Registration begins at 8:00 a.m.           Workshop schedule is 8:30-5:15

Eligibility: Persons  holding doctoral  degrees in Dentistry, Medicine, Psychology,  or Social  Work, or a Masters Degree in Psychology or Social Work and are licensed to practice in the state in which they practice. Persons holding a license in the state in which they practice as Licensed Professional Counselor. Current students of these disciplines. Nurses holding Masters  Degree who are  licensed in the state in which they practice.

CEU’s:  Certificates of Attendance provided. Approval for credit toward ASCH certification has been approved  for these workshops.

Target Audience:  These workshops are for intermediate to advanced practitioners though even those with basic knowledge could benefit. Further training and supervision is recommended.

NCPA Statement: The program is co-sponsored by the North Carolina Psychological Association and the North Carolina Society of Clinical Hypnosis. The North Carolina Psychological Association is approved by the American Psychological Association to sponsor continuing education for psychologists. The North Carolina Psychological Association maintains responsibility for this program and its content. The Carolyn Daitch workshop is offered for 7 hrs of continuing education credit. Saturday program will offer 6 hrs of continuing education credit.

Attendance Policy: To receive credit, you must be present for the entire workshop, and you must sign the sign-in and sign-out sheets. No credit will be given to participants who are more than 15 minutes late at the beginning of the workshop. No credit will be given to participants who leave before the close of the workshop.

Refund Policy: Refunds available  if cancellation before Sept 15 minus $25  fee.  No refunds if cancellation occurs after the start of the conference.

Lunch: Onsite, included with registration.

Lodging: go to Rigmor House website for details and locations of local hotel options. www.rigmorhouse.com

Contact:  Wayne Townsend at wtowns@mindspring.com  or 919-790-7922 or Sharyn Warren  at sewarren@mindspring.com or 919-467-3250.

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Registration Form

check one:       ___ curious beginner  ___ moderate experience     ___ advanced

Name  __________________________________________  Title /Degree 

Address __________________________________________ 

City _______________  Zip __________Phone _________________   

Email (print)______________________________________________________

NCSCH Dues $45  (you may join now and attend at the member rates)

Conference Fee 2 days                                             after September 5                            Location                     

Member                                  $175                $225                       

(nonmember)                          $250                $300                       

Workshop fees 1 day       

Member                                  $125                $145

Nonmember                           $170                 $195

(make payable to NCSCH)                    Total paid     $  _____________

MC / VISA  Card #  ______________________________________________ Exp Date 

 Signature ______________________________________

Mail form to:    NCSCH    c/o David Aspenson, PhD  111 Cloister Ct.  Ste. 100   Chapel Hill, NC 27514

Or fax to 919-771-0115