integrating inclusion: the implications of best...
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*Attendee Name (As per Licensing Board):______________________________________________________Practice/Company Name: __________________________________________________________________Address:_______________________ City/State/Zip: ___________________________________________Phone Number:___________________________________________________________________________ Email Address:___________________________________________________________________________
All * sections mandatory for Continuing Education reporting. All conference refunds subject to an administrative fee of $75 and cancellations must be in writing prior to October 2. Attendee contact information will be provided to exhibitors at the conference.
Speciality Infomation: Addiction Autism/Asperger’s Child/Adolescent Behavior Couples Counseling Crisis Intervention Depression Eating Disorders Academia Industry Retired Other _________________
Practice Infomation: Private Practice 1-2 Psychologists 3-5 Psychologists 6+ Psychologists
Wine Tasting Selection ($30 per bottle)
Blackberry Merlot Pinot Grigio Both
Payment Method: Check Enclosed Credit Card Amount: $______________Credit Card: Visa MasterCard Amex Credit Card Number:_________________________________ Expiration Date:_________ CV Code:________Cardholder Name:___________________________________ Credit Card Billing Zip Code: ______________Signature:__________________________________________ Date:____________ Total Paid: $___________
Return this form with payment to:
SCPA • 1215 Anthony Avenue • Columbia, SC 29201• T: (803) 820-0406 • F: (803) 254-3773 • Make checks payable to the South Carolina Psychological Association.
Online registration available at www.scpsychologists.net
Wine Bottle Shipping Address: Same as AboveAddress:___________________________ City/State/Zip: __________________________
South Carolina Psychological Association’s2020 Virtual Annual Conference
Join us online October 22-24
INTEGRATING INCLUSION: The Implications of Best Practices in Treatment
Full Conference(Friday & Saturday)
By 10/2/20
After 10/2/20
SCPA Member $275 $325
Non-member $325 $375
Student $80 $100
Featuring:
• Alexandra Karydi, PhD • David Treadway, PhD • A keynote address from Arthur Evans, PhD (APA)
On topics such as • Homelessness, LGBTQ, Couples Counseling, Eating Disorders, and APA Treatment Practices.
FRIDAY EVENING SOCIAL HOSTED BY CITY SCAPE WINERYExperience a taste of South Carolina by sampling a bottle of Pinot Grigio or Blackberry Merlot alongside sommelier and local winery owner Josh Jones. Wine will ship to you prior to the start of the conference*. Must be over 21 years old to participate. Signature and photo ID required upon delivery. Wine orders must be submitted by Oct. 12.*South Carolina address required