5/17/24 STAFF ONLY – Professional Development Workshop – Registration Page

Trauma Throughout the Lifespan

Presented by: Lucia Cucinotta, M.S.Ed., M.A.

Date: May 17, 2024

Time: 1:00pm – 3:00pm

Location: Virtual

5/17/2024 Trauma Throughout the Lifespan – Registration Form

*This workshop is virtual.

Name(Required)

First Last

Your Title (example: Occupational Therapist)(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Current CORA Staff

This virtual workshop is available to current CORA Staff ONLY.

Price:

Please provide your Act 48 Professional Personnel ID # (if not applicable, please put N/A)”(Required)

Which credits are you requesting?

ACT 48 CE Hours

SW, MFT & PC

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name