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.

Cancellation Policy: Registrants who cancel with at least seven days notice will be issued a full refund via the method of original payment. BWCC will use discretion in determining refund status for registrants who cancel with less than seven days notice.

 If you are having difficulty with this form, please e-mail: or call 410-768-6088 xt. 125.

At this time, BWCC processes payments online via PayPal or by mail-in check. 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 & submit the rest of this form and then mail your check to: Baltimore Washington Counseling Center and Training Institute 8258 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 *
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