REGISTRATION FORM

NAME _________________________________
ADDRESS
_______________________________
CITY
__________________________________
STATE
_____ ZIP________ COUNTRY _____________
TELEPHONE: HOME
____________ WORK ____________
FAX
__________ EMAIL _____________________
CEUs?
___ Check one. __MFT __LCSW



Please print and indicate in the list below the courses you are registering for. You must email the Institute for the current schedule of classes.

__ Advanced Practice Drama Therapy: Life Scripts (3 units)
__ Creative Arts Therapies (3 units)
__ Creative Drama (3 units)
__ Drama Theatre in Anger Management / Conflict Resolution: (1 unit)
__ Drama Theatre in Anger Management / Conflict Resolution: (1 unit)
__ Drama Therapy (3 units) *Offered as necessary
__ Drama Therapy with Children (1 unit)
__ Drama Therapy with Mood/Thought Disorders: Special Population (1 unit)
__ Drama Therapy with Physically and Developmentally Disabled Clients (l unit)
__ Drama Therapy for Special Populations: An Overview (3 units)
__ Drama Therapy with Special Populations: Substance Abuse/Dual Diagnoses (1 unit)
__ Integrating Drama Therapy Yoga Poetry and Creative Arts (l unit)
__ Narradrama Techniques: Integrating Narrative and Drama Therapy (1 unit )
__ Photography and Drama Therapy (1 unit)
__ Poetry Music Video and Drama therapy with Adolescents (l unit)
__ Ritual Ceremony and Mythic Theatre (1 unit)
__ Sociodrama/Psychodrama (3 units)
__ Video in Drama Therapy (l unit)

Supervision Classes and Professional Group
__ Drama Therapy Case Study (1 to 4 units)
__ Drama Therapy Monthly Professional Group
__ Ongoing Narradrama group (.5 units per class)

Registration Fees
3 Unit Class -- $489.00
2 Unit Class -- $338.00
1 Unit Class -- $169.00
Ongoing Narradrama Group -- $70 per meeting

There are no make-up lessons or reduction of class fee due to absences. A class time may be changed by the agreement of participants. All classes are held at 1315 Westwood Blvd. Los Angeles unless otherwise specified. For a more specific schedule of dates write to: Drama Therapy Institute of Los Angeles, 1315 Westwood Blvd. Los Angeles, CA 90024-4901. You may also call the Institute at: 310-226-2865