DSPP Fall Workshop Registration Form

Print form to mail in registration

DSPP Fall Workshop 1999 Registration Form

Stephen Mitchell, Ph.D.

You've Got to Suffer if You Want to Sing the Blues:
Psychoanalytic Reflections on Self-Pity, Guilt and Romance

Saturday November 13, 1999

________________________________Degree_______ Name
___________________________________________ Address
___________________________________________
___________________________________________
Office____________________Home________________ Phone
Membership Status	Fees
( ) Nonmember	$100.00
( ) Member	$80.00
( ) Student, includes lunch	$50.00
( ) On-Site Lunch *	$15.00
Total::	_______
*Please make check or money order payable to DSPP*
Please send completed registration and payment to: DSPP Fall Workshop c/o Sarah Aberg, LMSW-ACP 5646 Milton, #409 Dallas, Texas 75206 *All registrations requesting on-site lunch must be received by November 5, 1999