REGISTRATION
APPLICATION INFORMATION
ELIGIBILITY: These seminars are designed for psychotherapists seeking education in psychoanalytic psychotherapy. Registration is for either a sequence of seminars or for an individual course. For participants in treatment with one of the instructors, there is an opportunity to take a comparable course in one of the other programs.
READERS: Reading material is required for the seminars. Charges for reading material are separate and based upon copyright laws. The charges are due and payable upon receipt of the readers. Please submit your registration two weeks in advance in order to receive reading materials before the course starting date. Reading material is refundable upon return up to two weeks before the beginning of the course.
PAYMENT: Payment may be made by check or credit card. Unfortunately we do not accept installment payments.
CLASS SIZE: Registration for continuous seminars will be limited to the first 16 applications received. This limitation reflects a belief in the unique importance of small working groups for continuing professional development.
FEES AND PAYMENT POLICIES:
YEAR LONG SEMINARS: Fee for Healers, Lovers and Terrorists is $1,800; fee for Convergence and Divergence is $1,300; fee for East Bay Case Conference is $900; fee for Through a Lens Brightly is $1,000; a deposit of $300 is due with the application to secure enrollment. $300 is refundable until August 1, 2008. The remaining $1,500/$1,000/$600/$700 are due in full by August 15, 2008 and are not refundable. Foundations of Psychoanalytic Psychotherapy: Fee is $900; a deposit of $300 is due with the application to secure enrollment. $300 is refundable until November 30, 2008. The remaining $600 is due in full by December 15, 2008 and is not refundable; Foundations Alumni, 6 week course: fee is $150, payment is due with the application, no refund after December 15, 2008.
SEMINARS/PANELS IN EAST BAY AND PENINSULA: The fees are listed in the brochure. Payment is due with the application to secure enrollment. If an applicant withdraws three weeks prior to the starting date, a refund will be paid less $30 for a processing fee.
CHILD PSYCHOTHERAPY SEMINARS: Participation is limited to 12 applicants; fee: $1,400. Deposit of $300 to be included with application. $300 is refundable until August 1, 2008. The remaining $1,100 is due in full by August 15, 2008, and it is not refundable. Please include a brief description of your experience with children with your application. Readers will be provided; readers’cost is not included in tuition.
DISCOUNTED FEES: Only one form of a discount can be used for each registration.
Early Bird: a discount of 5% given to participants who register on or before June 11, 2008.
Students can deduct 25% from registration fees with student ID provided.
Friends of the San Francisco Center for Psychoanalysis can deduct 10% from registration fees.
APPLICATION
Name___________________________________License #_______________
Address________________________________________________________________
City, State, Zip___________________________________________________________
Phone(day)_______________________________(eve.)__________________________
Fax______________________Email_________________________________________
San Francisco:
Year Long Healers, Lovers & Terrorists______________________________Fee_________
Foundations of Psychoanalytic Psychotherapy___________________ Fee__________
Registrants should rank their preference for the elective session (1, 2, 3):
a minimum of five registrants will fill each elective
____ Dreams: Working with Dreams in Psychotherapy
____ Psychotherapy with Adolescents and Young Adults: Special Challenges
____Treatment of More Disturbed Patients in Community Mental Health, Hospital & Private Practice Settings
Child Psychotherapy Seminars: ___________________________________Fee_______
East Bay:
Year Long Convergence and Divergence____________________________Fee________
Year Long Continuous Case Conf._________________________________Fee________
Saturday Panel___________________________________Date__________Fee________
Peninsula:
Year Long Through a Lens Brightly_______________________Date_______Fee_______
Saturday Seminar______________________________________Date_______Fee_______
Saturday Seminar______________________________________Date_______Fee_______
Saturday Seminar______________________________________Date_______Fee_______
Saturday Seminar______________________________________Date_______Fee_______
Saturday Seminar______________________________________Date_______Fee________
Saturday Seminar______________________________________Date_______Fee________
Saturday Seminar______________________________________Date_______Fee________
Total Amount Enclosed $ ___________________________________________________
Check Enclosed_______Visa/MasterCard #___________________________________
Expiration Date_____________Signature_____________________________________
Billing Address_________________________________________________
Mail or Fax Application and Payment to:
San Francisco Center for Psychoanalysis (SFCP) Extension Division
2340 Jackson St, 4th Floor, San Francisco, CA 94115
www.sf-cp.org
Phone 415-563-5815; Fax 415-563-8406
E-mail: finance@sf-cp.org
The San Francisco Center of Psychoanalysis is accredited by the Institute for Medical Quality/California Medical Association (IMQ/CMA) to provide continuing medical education for physicians. The San Francisco Center of Psychoanalysis takes responsibility for the content, quality and scientific integrity of this CME activity.
The San Francisco Center of Psychoanalysis designates this educational activity for a maximum of credits as listed for each individual program, AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. This credit may also be applied to the CMA Certification in Continuing Medical Education.
PHYSICIANS: The San Francisco Center of Psychoanalysis designates this educational activity for a maximum of credits as listed for each individual program, AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity. This credit may also be applied to the CMA Certification in Continuing Medical Education.
L CSWs/MFTs: The San Francisco Center of Psychoanalysis is a provider approved by the Board of Behavioral Sciences, Provider Number PCE623, for # CME credits on an hour for hour basis.
PSYCHOLOGISTS: Psychologists attending SFCP events approved for CME credits may report AMA PRA Category 1 Credit(s)™ toward their CE requirements and are now able to directly submit their verification letters at the end of each renewal cycle using the MCEP credit reporting form that can be found on the internet at:
http://www.calpsychlink.org/accrediting_agency/files/MCEP_Reporting_Form.pdf
REGISTERED NURSES : The San Francisco Center of Psychoanalysis is a provider approved by the California Board of Registered Nursing, Provider Number 02677, on an hour for hour basis.
