Application Form

Name
Address
City, State, Zip
Phone
Email
Occupation
Clinical License

Which program would you like to apply for?
Weekend Training Program
Residential Program
Introductory Workshop

Payment Method
PayPal
Mail-in Form
Faculty:
Ann Bartelstein
M.F.T.
Lynne Jacobs
Ph.D.
Lillian Norton
M.D., M.F.T., L.A.D.C.
Jan Ruckert
Ed.D.
Friedemann Schulz
M.F.T.
Gary Yontef
Ph.D., F.A.Clin.P.
1626 Westwood Boulevard, Suite 104
Los Angeles, CA 90024
Tel: (310) 446-9720
Fax: (310) 475-4704