Boston NeuroDynamics Training Registration Form - May 2021
To register for the January 2021 Online 36-hour BCIA approved Introduction to Neurofeedback please fill out the following information.
Email address *
First Name *
As you would like it to appear on your certificate
Last Name *
Name as you would like it to appear on your certificate *
Suffix (ie. PhD, RN, LICSW) *
Address Line 1 *
Address Line 2
City *
State *
ZIP *
Country *
Email *
Phone Number *
How did you hear about us? *
Required
If you were referred to us, who do we have to thank?
May we share your email address with other training participants? *
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