2022 GUIDELINES, STANDARDS & ETHICS of Tele-Mental Health (3 CEH) TUITION each 3 HR EACH SESSION: $90.00 LCA MEMBER: $85.00 PLPC/PLMFT: $80.00 Please scan and email the registration and you may pay the tuition at the training by cash, check, or money or

2022 GUIDELINES, STANDARDS & ETHICS of Tele-Mental Health (3 CEH)

TUITION each 3 HR EACH SESSION: $90.00    LCA MEMBER: $85.00            PLPC/PLMFT: $80.00

Please scan and email the registration and you may pay the tuition at the training by cash, check, or money order. CC Payments can be processed through PayPal but there is an additional fee for processing

PAYMENTS CAN BE MADE USING THE ZELLE APP BY USING MY PHONE # or Email

These trainings meet the requirements for the required Continuing Education for Ethics

3 DEC 2022              TMH: 9:00 – 12:15

LOCATION:               El Shaddai Education Center, 304 Ingleside Drive, Monroe, LA 71203

PAYMENT TO:     STAN MAHAFFEY, 621 North Polk Av, JONESBORO, LA 71251

Cell: 318.237.0711 E-Mail: stanmahaffey1@gmail.com

REGISTRATION (PLEASE PRINT or TYPE Legibly)

Training sessions are scheduled at facilities that comply with ADA guidelines Please indicate if you require special accommodation

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NAME

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HOME / WORK/CELL PHONE

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E-MAIL ADDRESS

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“Counseling & Consulting Services is an NBCC-Approved Continuing Education Provider (ACEP) and may offer NBCC-approved clock hours for events that meet NBCC requirements. The ACEP solely is responsible for all aspects of the program.”