Fall Conference Registration

OPA Psychotherapy Section's 2019 Fall Conference

Bridging science and practice: how long does change really take in psychotherapy?

Saturday, October 26, 2019
The Estates of Sunnybrook
2075 Bayview Avenue, Toronto, Ontario

Space will fill up quickly so book early to avoid disappointment!

All fields marked with an asterisk (*) are required

Contact Information

First name: *
Last name: *
Company:
Address *
Suite #
City: *
Province/State: *
Country:
Postal/Zip Code: *
Email: *
Phone: *
Fax
Website

Privacy Policy for Conferences

Personal information collected on this form will only be used for purposes of conference administration.

I consent to have my information used to provide me with OPA communications.

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Fees Selection

Full Conference (includes breakfast, luncheon & refreshment breaks.) *

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OPA Member - Full: $

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OPA Member Associate/Life/Inactive/ Honorary: $

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OPA Member - Resident: $

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Non Members – Physicians: $

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Payment Information

Subtotal:	0.00
Tax (13% HST) HST #12042 8529 RT0001:	0.00
Total:	0.00
Name on Card: *
Credit Card Number: *
Expiration (MM/YYYY): *	/
CVC: *

First Name*
Last Name*
Company*
Email:*
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