Cornerstone of Hope · CLE_2024 Support Group Facilitator Training Registration

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Support Group Facilitator Training Registration

Cornerstone of Hope, Independence

August 15-16, 2024 (must attend both days) • 9:00AM-4:00PM

Amount *	Quantity
$295 - August 15-16, 2024

Contact Information

Name

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Phone Number

Verify Email

Organization/Employer

Organization/Employer Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Organization/Employer Phone

Professional/Volunteer or other experience with grief and loss, mental health or group facilitation:

Current Professional Licensure if applicable:

What is your general availability/preference to facilitate groups?

(For example: weekday evenings, weekday mornings, weekends, etc.)

How did you hear about this training?

Quarterly Newsletter

Social Media

Website

Print Ad

Flyer

Other

By completing this registration, I understand that photos/video/audio may be taken and utilized for marketing and fundraising. No names or identifying information will be used without permission.

Payment Note:

We use Paypal as our "cashier"; Paypal account is not necessary and you may pay using any form of payment that you choose. Please call our offices with any questions: 216.524.4673.

Add 3% to my total amount to help cover the payment processing fees