Mindfulness-Based Cognitive Therapy
Presenter: Susan Woods, M.S.W., L.I.C.S.W.                                                                                  5 CEUs

Registration 8:30 a.m.      Program 9:00 to 3:00
Friday, September 26, 2008       Vermont Technical College -    Old Dorm - Randolph, VT  
Print this page to mail with check OR fax with credit card payment (see below).

Please mail with payment to: NASW-VT Chapter, PO Box 1348, Montpelier, VT 05601

Name:_____________________________________________________________________

Address:___________________________________________________________________

Town:__________________________________State:________Zip:___________________

Phone:______________________________ NASW#_______________________________

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***Confirmations will be sent via email ONLY. If one is not available to you, please call
(toll free) 1-888-260-7398 to receive confirmation. Directions will be included in confirmation.

                                Early rate registrations must be postmarked by August 26, 2008.  Final Registration deadline  
                                                     is September 19, 2008     *see below for late registration fee

IF YOU ARE PAYING ONLINE THROUGH PAYPAL, PLEASE PRINT, FILL OUT AND FAX THIS FORM TO THE NASW-VT OFFICE: 802-229-4318 and follow instructions below. If paying by check, form and check must be mailed to: NASW-VT, PO Box 1348, Montpelier, VT 05601

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Registration Fee Includes: · Coffee, tea, juice, a continental breakfast, lunch, and afternoon snack· 5 Continuing Education Units ·
Conference materials · Vegetarian lunch selection

Early rate must be postmarked by 08-26-08. *Registration after final deadline of Sept.19, 2008 and/or DAY OF:  Additional $15.00