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FDA/CE Certifications
Distance Learning - Reading Program for MFT's

Register by Mail
(to register online, click on the link for the book you are interested in: approved books)

Instructions:
1.
Print this form.
2.
Send the completed registration form along with payment to FDA/CE.
You will receive your exam in the mail within 2 weeks, or via email within 24 hours.
3.
Finish the exam and Evaluation Form, and return them to FDA/CE for CE credit.
-----------------------------------------------------------------------------------------------
NAME:____________________________________________
(as it appears on license)
LICENSE TYPE & NUMBER _________

ADDRESS_________________________________________

CITY_____________________________________________

 

 

STATE______

 

 

ZIP__________

 

TELEPHONE: daytime: ( ....)________________ evening: (....)____________________
E-MAIL ADDRESS:________________________________
Exams I am registering for:  
_____________________________________________ Cost: $ _______
_____________________________________________ Cost: $ _______
_____________________________________________ Cost: $ _______
SHIPPING & HANDLING:  email or web site download delivery Cost: $  -- 0 --
SHIPPING & HANDLING:  printed hard copy delivery       ($7.50) Cost: $ _______
ENCLOSED:
Total $ _________
Send completed registration form and payment to:
FDA / CE Certifications
40 SPEEN ST., #106
FRAMINGHAM, MA 01701
For further information call: TOLL FREE: 800-814-9100 ext.6
ATTN: Michael Vickers, PhD, LMFT.
email to: m-vickers@comcast.net

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