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)

Training Location:

Fairfield Inn & Suites Detroit Livonia

17350 Fox Drive Livonia, MI 48152

734-953-8888 ext. 501

www.fairfieldinnlivonia.com

Rate $119 ask for the Cooperative Training Rates

Training Fee:

$525.00 Early Bird Fee (up until 9/27/18)

$550.00 Full Fee

Training Includes:

  • 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 cpiandfs@gmail.com

To Register

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.

Name: _____________________________________________________________

(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: (______) ______________

E-Mail: ___________________________________________________________

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

cpiandfs@gmail.com

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 cpiandfs@gmail.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 ________________________________________________________________

Date _____/_____/______