This online form processes real-time payment by credit card. If you wish to pay by cheque you can still register now using this online system. A confirmation will be sent when payment is received. Please make cheques payable to Jack Hirose & Associates and mail to 1770 Orkney Place, North Vancouver, BC, Canada V7H 2Z1.
Phone 604-924-0296, Toll-free 1-800-456-5424, Fax 604-924-0239
Email registration@jackhirose.com | www.jackhirose.com


 

IDENTIFICATION | See privacy policy required fields = bold *

Honorific

Please keep me informed
about future workshops*


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AFFILIATION


 

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Other details about this registration. If registering a group, enter the names of group members and the team leader first. Each person must be registered individually.
CHOOSE WORKSHOP

You will see the registration options after you select an event.


2009, VANCOUVER, BC: 4-Day Intensive Workshop on Cognitive Behavior Therapy with Dr. David Burns, M.D.
MISSISSAUGA: Feeling Good Together with Dr. David Burns, M.D., November 24 & 25, 2008
VANCOUVER: The Explosive Child with Dr. Ross Greene, Ph.D., December 5, 2008
DUNCAN: Bullies: Their Making and Unmaking with Dr. Gordon Neufeld, Ph.D., November 27 & 28, 2008
MISSISSAUGA: Anxiety Disorders in Children with Dr. Paul Foxman, Ph.D., December 1 & 2, 2008
WINNIPEG: Anxiety Disorders in Children and Adolescents – Recognizing and Treating the Emerging Epidemic with Dr. Paul Foxman, Ph.D., Dec. 12, 2008
2009 MISSISSAUGA 4 Day Intensive Workshop on Cognitive Behavior Therapy with Dr. David Burns, M.D.

   

Privacy Statement


What information is collected and how it is used
Personal data collected through this site consists of information submitted voluntarily during the registration process, including your name, job title, organization, mailing address, telephone and fax numbers and e-mail address. Access to data is limited to staff of Jack Hirose & Associates and others authorized to process registrations and organize the workshop.

Online conference registration and credit card processing
All credit-card payment information is communicated using the industry-standard SSL 128-bit encryption. Look for the lock in your browser window to confirm this. Credit-card information is NOT stored; transaction and authorization codes are.

© 2008 | JACK HIROSE & ASSOCIATES