REGISTRATION FORM

Special Workshops on Relationship Enhancement® and Filial Methods

Held in Conjunction with the 2008 AFREM Annual Meeting

April 11-13, 2008

The following information may be supplied by phone, fax or by mailing the completed form
Phone: (301) 986-1479          Fax: (24 hours, 7 days) (301) 680-3756
Mail: IDEALS/NIRE, Administrative Office,
12500 Blake Road, Silver Spring, MD 20904-2056

Cost and Refunds: The fee for each 3-hour workshop is $55. The fee for the day long workshop on Friday is $110.00. The fee for currently enrolled, full-time graduate students is $20.00 for each 3-hour workshop, and $40 for the day long workshop on Friday. If you are unable to attend, you may choose a full credit applied to any future IDEALS/NIRE workshops or a refund less a $25 service charge, if notification is given three days prior to the workshop. In the unlikely event that the program is canceled, registration fees will be fully refunded. 

Please register me for:
   __ April 11, Using Advanced Relationship Enhancement Techniques to Deepen Dialogues
      and Deal with Couples' Impasses and Crises
      __ $110.00  Full-time students only: __ $40.00

   __ April 12, Relationship Enhancement: An Emotionally-focused Approach
      __ $55.00  Full-time students only: __ $20.00  

   __ April 12, The House and the Hammer:  How Generalization of RE/Filial Skills in
      Our Lives Makes the Core Difference in Our Work
      __ $55.00  Full-time students only: __ $20.00  

   __ April 13, Promoting Filial Therapy Training with Head Start, Foster and Adoptive,
      and Other Social Service Agencies
      __ $55.00  Full-time students only: __ $20.00


__ Yes, I would also like to have a box lunch on Saturday for the AFREM annual
   meeting.  __ $10.00
   __ Turkey   __ Roast Beef   __ Tuna Salad   __ Chicken   __ Veggie and Cheese

__ Yes, I would like to attend the Saturday night dinner (Dutch treat) dinner.
   Number of people to attend: ___.

Name: ____________________________________________________________________________

Highest Degree: ____________ Field/Credentials: __________________________________

Work Setting/Position: ___________________________________________________________

Agency or Organization: __________________________________________________________

Business Address: ________________________________________________________________

__________________________________________________________________________________

Home Address: ____________________________________________________________________

__________________________________________________________________________________

Business Phone: (_____) _____ - ________ Home Phone: (_____) _____ - ________

E-mail address (please print clearly): ___________________________________________

Indicate method of payment:

__ My check, payable to IDEALS/NIRE, is enclosed for $_______________.

Or, please charge my: __ VISA  __ MasterCard $_______________.

Card #: _________________________________________________ Exp. Date:______________

Name exactly as it appears on the card (please print):____________________________

Cardholder's Signature: __________________________________________________________