An Overview of Psychoanalytic Business and Organizational Consulting

This page may be printed and mailed 

SEMINAR REGISTRATION

Name/Degree______________________________________

Address___________________________________________

City_______________________________________________

State/Zip__________________________________________

Home Telephone___________________________________

Office Telephone___________________________________

Email Address_____________________________________

Place of Employment_______________________________

E-Mail Address____________________________________

Graduate Program _________________________________

Full Time Student/Resident at_______________________

Check must accompany registration. $250 (full time students and residents $125)

Please pay to/mail with registration to:  Baltimore Washington Institute for Psychoanalysis, Inc.

14900 Sweitzer Lane, Suite 102, Laurel, MD  20707.