We can't wait to have you join EFIT!

Group registration is a two-step process. Please start by completing the following form online. Once received, we'll email you a group registration invoice, within 24 hours, equal to the cost of one group, via Square. You can secure your spot in group by paying the invoice. Your registration isn't confirmed until you have paid the invoice and received payment confirmation. Please note this deposit is non-refundable.

Should you have any questions or problems, please email Jill directly at jill@mendcouplestherapy.com

Name

First Name

Last Name

Email Address

Phone

(###)

###

####

Mailing address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

I am registering for:

EFIT Supervision Group with Jill Soyka, LCSW

EFT Training Experience (please check all that apply):

EFT Externship

EFT Core Skills

Core Skills Plus

2-day EFIT special topics training

Please read and agree to the following:

I am a licensed mental health professional in good standing with my licensing board or a resident working towards licensure under the direct supervision of my registered supervisor.

My registration payment of $80.00 is non-refundable.

I will pay for all group sessions, regardless of my attendance.

We can't wait to have you join EFIT!

Should you have any questions or problems, please email Jill directly at jill@mendcouplestherapy.com

Mend Couples Therapy, LLP