Borderline Personality Disorder:
New Clinical Approaches

Houston, Texas      ▪        March 28, 2008
Registration

Print this form, complete and mail it to:

Education Office

The Menninger Clinic

2801 Gessner Dr

Houston, TX 77080

 

If paying by check, please make the check payable to “The Menninger Clinic”

 

OR, if you'd like to register online, click here

Name

Discipline (circle one)

MD PhD/PsyD MSW LPC RN LMFT LCDC Other (specify)_________

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Organization/affiliation
Address
City State Zip code
Daytime phone

E-mail
Rates
□ Professional $160 (Early bird discount is $95 when registering by March 7.)
□ Trainee/student $80 with valid ID
□ Individual family member $45  
□ Consumer $20  

Rates include continental breakfast and lunch.
       
Payment    
Credit card type (circle one)    
  MasterCard  Visa Discover American Express
Credit card number
Expiration date (MM/YY)
Print name as it appears on card
Billing address (If same as above, please check .)

Cardholder’s signature

 
 

 

 

 

 

 

 

 

 

 

 

© 2005-2008 National Education Alliance for Borderline Personality Disorder

PO Box 974, Rye, New York 10580
914-835-9011

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