Online Registration Form

FORM INSTRUCTIONS
Complete all steps of registration.

1.- Enter information in all fields.
2.- Click "submit "
3.- Check your e-mail for confirmation of registration
4.- A representative will contact you to finalize your registration.

Early Registration fees valid only prior to March 5th, 2010 (Regular fees begin March 5th)

Breakout Sessions
Selections will be honored on a first come first serve basis. Space is limited.
Register early to help secure your spot!

Students
*Must show proof of student status: Copy of valid Student ID or letter from professor on University letterhead

- All Fields are Required for Online Registration -

First/Last Name
Agency
Phone Number Best Time to Contact
E-mail
Address	Office Home
Street/Apt/Suite
City/State/Zip
License Held Select all that Apply	LPC LMFT Social Work School Counselor RPT Licensed Psychologist Other
Counseling Workplace	Select OneCommunity CounselingSchool CounselingPrivate PracticeUniversityOther
Friday March 26th Registration Fee	APT/TAPT Regular Member $155 APT/TAPT Student Member* $115 Non-APT/TAPT Member $265 Will Not Attend
Saturday March 27th Registration Fee	APT/TAPT Regular Member $155 APT/TAPT Student Member* $115 Non-APT/TAPT Member $265 Will Not Attend
Sunday March 28th Registration Fee	APT/TAPT Regular Member $85 Will Not Attend
Sectional Selections for Saturday	3 Hour Session 10:45am-3:00pm 1.5 Hour Morning 10:45am-12:15pm and 1.5 Hour Afternoon 1:30pm-3:00pm Will Not Attend
3 Hour Session 1st Choice	Select OnePlaying by the RulesSandtray TherapyChild Parent RelationshipPT for Sexual AbuseDoes Not Apply
3 Hour Session 2nd Choice	Select OnePlaying by the RulesSandtray TherapyChild Parent RelationshipPT for Sexual AbuseDoes Not Apply
List Morning 1st Choice 10:45am-12:15pm	Select OnePrioritizing ParentsBuilding RelationshipsPlay Therapy AttitudeDoes Not Apply
List Morning 2nd Choice 10:45am-12:15pm	Select OnePrioritizing ParentsBuilding RelationshipsPlay Therapy AttitudeDoes Not Apply
List Afternoon 1st Choice 1:30pm-3:30pm	Select OnePlaying ThroughChildren in TherapyImpact of School-BasedDoes Not Apply
List Afternoon 2nd Choice 1:30pm-3:30pm	Select OnePlaying ThroughChildren in TherapyImpact of School-BasedDoes Not Apply
Lunch Selection	Vegetarian Traditional Special Need*
*Specify
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txapt.org reserves the right to change this policy. If we do make changes, the revised privacy policy will be posted on this site.

Friday
March 26th, 2010

7:30am-8:30am
Registration and
Continental Breakfast
8:30am-5:00pm
Keynote Speaker:
Daniel Sweeney,
Ph.D., LPC, LMFT, RPT-S
The Neurobiology of
Trauma & Play Therapy
12:00pm-1:30pm
Lunch (included)
5:30pm-8:15pm
Special Event: Dance Class and Auction

Saturday
March 27th, 2010

7:30am-8:30am
Registration and
Continental Breakfast
8:30am-10:15am
Keynote Speaker: Garry Landreth, Ed.D., LPC, RPT-S Touching What is
Untouchable in a Child's Life in Play Therapy
10:45am-12:15pm
Breakout Sessions
12:15pm-1:30pm
Lunch (included)
1:30pm-3:00pm
Breakout Sessions
3:30pm-5:00pm
Closing Keynote Speaker: Garry Landreth,
Ed.D., LPC, RPT-S The Dynamic Inner Dimensions of the Play Therapy Relationship: My Personal Learning
5:00pm Adjourn

Sunday
March 28th, 2010

8:00am
Continental Breakfast
8:30am-12:30pm
Keynote Speaker:
Brandy Schumann
Ph.D., LPC-S, NCC, RPT-S
12:30pm
Adjourn