Pragmatic Language Skills Registration Form - Continuing Education - Applied Psychology - Antioch University New England
What Can I Say? What Did You Say?
Developing Pragmatic Language Skills for Social Interaction
Please print, fill out, and mail this form to:
Shelley Viles
Director of Continuing Education
Department of Applied Psychology
Antioch University New England
40 Avon Street
Keene, NH 03431-3552
What Can I Say? What Did You Say?
Developing Pragmatic Language Skills for Social Interaction
___ November 5 and 6, 2008,
___ December 10 and 11, 2008
___ March 25 and 26, 2009
First Name:_____________________________________________________________________
Last Name:______________________________________________________________________
Occupation:_____________________________________________________________________
Company Name:___________________________________________________________________
Mailing Address:________________________________________________________________
City/State/Zip:_________________________________________________________________
Day Phone Number:__________________________________
Evening Phone Number:______________________________
Email:_____________________________________________
Fees
Professional fee: $299
Discount rate per person for family members of an individual with a social communication deficit: $259
Late registration fee, within 14 days of the event: $329
Checks and purchase orders accepted. Antioch Tax ID #310536640.
Checks should be made payable to Antioch University New England.
Check enclosed $_______________ Purchase order enclosed $_______________