BDMTS Facilitator Registration

Facilitator Information
Name
  Last First Middle
Address
  Street Address Apt/Unit
 
  City State Zip Code
Work Phone Cell Phone
Email Address
 
Hosting Organization Information

If currently working for an institution that plans to provide the Bodiography® Dance Movement Therapy program at their location, complete the information below. If not currently working for an insitution, omit this portion of the registration.

Company
Address
  Street Address Apt/Unit
 
  City State Zip Code
Phone Director/Contact
 
Payment Information

The cost of a Bodiography® Dance Movement Therapy training is $350 per participant. This includes the price of the manual, but does not include anything additional during the course of the training.

Please make checks out to "Bodiography".

Bodiography® promises to keep all information private and to be used exclusively for official Bodiography® Fitness and Strength use.

Payment Type      
 
Bodiography® Dance Movement Therapy
5824 Forbes Avenue, Floor 3
Pittsburgh, PA 15236

Please contact our Program Director, Melissa Tyler, at melissa@bodiographycbc.com with any questions.