Registration - 4th International Conference

*First Name:

*Last Name:

*City Of Residence:

*E-Mail Address:

*Telephone Number:

*How did you hear about the Conference?

*How do you plan to attend the Conference?
In-Person
Virtually

*Are you part of an existing Bowen Network?
Yes
No

Name of Bowen Network

*How long have you been studying Bowen Theory?
1-5 Years
5-10 Years
10+ Years

*Would you like to receive future information from the Florida Family Research Network (FFRN)?
Yes
No

*Conference Registration Type:
Standard $450
Student/Pre-Licensed Registered Intern $75
Institutional Rate (10+) $3950

Student ID / Registered Intern License

Name of Academic Institution (Required for students and pre-licensed registered interns)


15 CEUs: $50
No CEUs: $0

CEUs are valid for Florida licensed psychologists and masters level clinicians (social work, marriage and family therapy, mental health counseling).

Licensure Number (Required if choosing CEU option)


Lunch: $50 (Onsite packed lunch for 3 days)
Yes
No

Dinner Cruise (limited to the first 100 registrants):
No - $0
Registrant: $125
Registrant + 1 guest: $250
Registrant + 2 guests: $375
Registrant + 3 guests: $500

Total: $0

Clicking the Submit button will re-direct you to PayPal to remit the registration fee. Please do not close your web browser for at least 10 seconds after payment to secure payment process.