Michigan Parenting Coordination Training
Training meets the requirements of the Michigan PC Statute
and AFCC Guidelines
Continuing Education (20 CEU): NASW/ NCC
Date: October 18-20, 2018 (Thursday- Saturday)
Fairfield Inn & Suites Detroit Livonia
734-953-8888 ext. 501
Rate $119 ask for the Cooperative Training Rates
$525.00 Early Bird Fee (up until 9/27/18)
$550.00 Full Fee
- A copy of Cooperative Parenting and Divorce; a Parent Guide to Effective Co-Parenting
- A copy of Parenting Coordination Reference Manual, formerly published asPsychotherapist as Parenting Coordination in High-Conflict Divorce.
- Breakfast each morning from 8:00-8:30 am.
- Basic electronic parenting coordination forms for personal duplication
- Free listing on www.parentingcoordinationcentral.comand parenting coordination listserv.
20 hr. Training Schedule: Each daybegins at 8:00 am for breakfast and training begins at 8:30 am-5:00 pm with the exception of Saturday which ends at 4:00 pm. Each training day has a short morning and afternoon break and a one hour lunch on your own. You must attend all 20 hours for you to receive your certificate with 20 hours of training.
Trainer: Susan Boyan, LMFT has over 38 years clinical experience. She has been training parenting coordinators since 1997 and is a recognized international expert on divorce and parenting coordination. She is the co-author of Parenting Coordination Reference Manual, Crossroads of Parenting and Divorce, The Co-Parent Communication Handbook andCooperative Parenting and Divorce.For more informationcontact Susan at 404-273-3370 by text or voice mail, or email at firstname.lastname@example.org
Go to the training on line registration form or complete the registration form attached.
NOTE: Two weeks prior to the training date you will receive daily outlines and handouts electronically. You will need to print and bring these to the training. Also bring a print copy of your Michigan PC Statutes.
Cooperative Parenting Institute
Michigan Parenting Coordination Training Registration Form
CEUs -NASW/ NCC/GAMFT
Please print legibly and neatly. Some of the information will be included on your certificate.
(As you would like it to appear on your certificate. Include credentials after your name if you would like them included on your certificate)
Credentials: _____ Masters _____ Specialist _____ JD _____ Doctorate ____ Other
Profession: ___ Psychotherapist ___ Social Worker ___ Psychologist ___ Mediator ___ Attorney ___ Judge
License & Number (if applicable): ____________________________________
Business Address: _________________________________________________________________
(street) (city/town) (state) (zip code)
Business (______) _______________ Mobile Phone: (______) ______________
How did you hear about the training? ___ E-Mail ____Colleague ___Website ____AFCC ____ Ad ___ Social Media
Check Training Location:
___ Livonia, MI: (October 18-20, 2018) Meets MCL 722.27c Statute
Check Training Hours/Fee:
_____ 20 hr early bird $525 Full fee $550
_____ 24 hr early bird $590 Full fee $615 NC participants
_____ 26 hr early bird $635 Full fee $660 LA participants
Early bird rate good until 3 weeks prior to the training
Visit www.cooperativeparenting.com for learning objectives and basic outline.
Payment Amount: $__________
______ I will mail this registration form with my check or money order (payable to CPI) to Susan Boyan at the Cooperative Parenting Institute at 1936 A. North Druid Hills Brookhaven, GA 30319
______ I will fax or email this registration and with a permission to charge to Fax: 404-982-0006, or email@example.com. Add $15 for all charges.
CHARGE CARD PERMISSION
Card Number _________________________________________ code ________
Expiration Date ______/________/______ Billing Zip Code ________________
I grant permission for my training fee (plus a $15 charge) be charged to the number above for the one time total of $_________.
Print Name of Card Holder ____________________________________________________________
Authorized Signature ________________________________________________________________