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Workshop Registration Form
PORTLAND INSTITUTE FOR LOSS AND TRANSITION
When Grief Goes Viral
Psychological Assessment and Intervention in the Corona Crisis
May 29, 2020 (Friday), 9-11am, PDT or
June 8, 2020 (Monday), 9-11am, SGT
IMPORTANT! Site members please log in to link your data from the certification program.
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Personal Particulars: (for site members, please login to auto fill the basic information)
*First Name
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*Family Name
*Phone
*Email Address
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*City
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*Country
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Professional Background
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*Discipline
Psychologist
Social Worker
Counsellor / Therapist
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Marriage & Family Therapist
Physician / Nurse
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Art or Expressive Arts Therapist
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Dear participant,
To purchase the certificate program requires you to complete your learner profile. Please click the button below to complete your learner profile (another page) before we can process your registration.
Dear participant,
To join the certificate program requires you to create a learner profile on our site. Please set a password and complete your profile (another page) before you register the event. You will be able to login with your email and password.
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Registration
Join this live online workshop with an accompanying Course Pack, as well as the opportunity to
interact through breakouts and the question and answer period.
*One registration is only intended for one participant and cannot be shared among multiple learners.
Please kindly indicate which session you would like to join:
May 29, 2020 (Friday), at 9-11am, PDT: USD$99
June 8, 2020 (Monday), at 9-11am, SGT: USD$99
NOTE: for registrants who wish to purchased certification program,
the total price will be above price + $100 certification fee
Yes, I wish to add the Certification Program to my order
**Participants in this online workshop are eligible for certification credit for 1 Technique Module.
Event Subtotal (USD):
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Terms and Conditions
1. You will receive a confirmation of registration via email upon payment completion.
2. Refund policy
Should you be unable to attend the “When Grief Goes Viral” online workshop as registered, you may write in to the Portland Institute (PI) to request for withdrawal and refund according to the following guidelines:
a) 1 week before workshop commences: refund minus 10% service fee
b) Within 1 week before workshop commences: No refund permitted
3. PI reserves the right to make any necessary changes to the workshop program without prior notice to the registrants.
Agreement
By registering for the “When Grief Goes Viral” online workshop, I acknowledge and agree with the above-mentioned terms and conditions. I consent to the use of my personal data and payment details for this registration.