Registration Form

AAMFT-CA Networking District: Inland Empire

Fill in the form below to sign up for a district meeting. Please make sure that your email address is correct.

Attendee Information *required fields

Membership Number:

Name:*

Address:*

City:*

State:*

Zip:*

Phone:*

Fax:

email:*

Are you a member of AAMFT?:

Receive AAMFT Member Info:

Single Event

Students: $15

AAMFT Member: $25

Non-Member: $35

Upcoming Events

Building Your Private Practice 

  • Friday, May 9, 2008
    12:00 noon to 3:00 p.m.
  • Location: California Baptist University
    San Bernardino Campus
    225 W. Hospitality Lane, Suite 108
    San Bernardino, CA 92408-3244

Credit Card Information

Name on Card:*

Credit Card Type:*

Card Number:*

Expiration:*

Please Note that if you receive an error when submitting this form, use your browser's "Back" button to return to this form.

Registrants not attending the meeting or failing to cancel their registration by Friday, two weeks prior to their session, will be invoiced for the full fee. There is a $20 fee for returned checks or denied charges to credit cards.