REGISTER FOR A TRAINING

Please complete this form in full for your desired training and click submit button below to be redirected to payment information page. Failure to complete all required fields may affect registration and CEU certificate. Upon receipt of your payment, you will receive a confirmation e-mail with information regarding your training. If you are having difficulty with this form, please e-mail: 
traininginstitute@bwcc-counseling.com or call 410-768-6088 xt. 125.

At this time, BWCC processes payments online via PayPal only. When you submit this form, you will be directed to PayPal to process payment, if you choose to use that method. If you would like to pay for a registration by check, please complete the form below and then mail your check to: Baltimore Washington Counseling Center and Training Institute: 8528 Veterans Highway, Suite 13, Millersville, MD 21108
Attendee Name *
Attendee Name
Attendee Phone Number *
Attendee Phone Number
Name of Person Completing Registration (if different from attendee above) *
Name of Person Completing Registration (if different from attendee above)
*Specify "same as above" if applicable
Address *
Address
Phone Number
Phone Number
*If different from attendee phone number above
Fax Number
Fax Number
BWCC will never share your information or spam your e-mail