Express Yourself Winter Programs 2013-2014
Intensive Creative Arts in Therapy Certificate (ICAT)
Healing through Expressive Arts (HEAT)
Registration Form
Place a check mark in the boxes of the workshops you wish to take. Payment
information follows.
Presenter
Course
Date
Laura Simms
(ICAT)
Therapeutic Storytelling Skills
Oct 24-25
What a Beautiful Road: The
Healing Power of Presence and
Storytelling
Oct 26-27
Laura Simms
(HEAT)
Kate Donohue
(ICAT)
Introduction to Expressive Arts
Therapy Part 1: Deepening
Psychotherapy when guided by
Images
Kate Donohue
(HEAT)
Kinship Libido: Healing through
Relationship
Nov 23-24
Armand Volkas
(ICAT)
Drama in Counselling Skills
Jan 16-17
Armand Volkas
(HEAT)
Healing the Wounds of History
through the Arts
Jan 18-19
Kate Donohue
(ICAT)
Expressive Arts Therapy Part 2:
April 24-25
Restoring Safety to the Shattered
Temenos: Individual and
Collective Trauma,
Neurobiology, and Attachment
Kate Donohue
(HEAT)
Transcendent Journey through
the Mother-line
Nov 21-22
April 26-27
Total
Courses
Attending
Personal Information
Name:
Address:
Home Phone:
Cell:
Email Address:
Agency Name, School, Clinic:
Payment
Non-refundable Deposit
(Due by Sept. 15, 2013)
$100
$100
1-3 Courses
$375 X _____courses
_______
All four courses ICAT or HEAT
$325/course = $1300 Total
(Payable in two installments Sept. 30, 2013 and Jan. 16, 2013)
_______
Combined Series
1-3 Combined ICAT/HEAT Courses $495 X ____ courses
________
Complete Combined Series All ICAT/HEAT Courses
$475/course X 4 courses = $1900
_________
Total owed
_________
Total payment
Date:
__________
Total payment
Date:
__________
Total payment
Date:
__________
I agree that my photo may be taken during this program for promotional or
educational use. Signature: ______________________________________