Registration — EMDR New Mexico

EMDR New Mexico

Online Registration Form

Margaret V. Moore, LISW
EMDR Trainer
2418 Miles RD SE
Albuquerque, M 87106
505-247-8915

Name

First Name

Last Name

Professional License, Association

Address

Business address:

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone

(###)

###

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Select

Please select training/fee:

Payment Information

Please indicate whether you will pay online below (using Paypal) or mail a check payable to Peggy Moore, LCSW, 2418 Miles Rd SE Albuquerque, New Mexico 87106. A deposit of $100 will hold your spot and is nonrefundable after 7 days prior to training. Reservations will close 7 days prior to the Training.

Notes

Any message, questions or requests.