When

Monday, January 27, 2020 at 8:00 AM EST
-to-
Wednesday, January 29, 2020 at 5:00 PM EST
Add to Calendar

Where

Boston Children's Hospital Waltham

9 Hope Avenue
Deveber Room
Waltham, MA 02451

Driving Directions

Contact

Mai Nguyen-Kim
Brazelton Touchpoints Center
617-919-3238
mai.nguyen@childrens.harvard.edu

January 2020 Touchpoints Individual Level Training

January 27-29, 2020 Touchpoints Individual Level Training in Waltham, MA.

* Required information

Personal Information

* First Name:
* Last Name:
* Email Address:
* Confirm Email Address:
Years in the field
Degree
* Address 1:
Address 2:
* City:
* State:
* ZIP Code:
* Phone:

Fee

Type	Fee
Early Bird Training Fee (10% discount) $1,350.00 after Sunday, December 15, 2019	$1,215.00

Business Information

* Company:
Address 1:
Address 2:
City:
State:
ZIP Code:
Touchpoints Site Name, if applicable
Phone:
* Job Title:

Badge Information

Badge Name:

Training Registration Information

Current Professional Responsibilities
- Direct Service Staff
- Supervisory Staff
- Program Management Staff
- Executive Leadership
- Other
If Other professional responsibilities (please specify)
Ages of Children Served
Organizational Leader (Exec. Dir./CEO)
Brief professional experience/history
characters remaining
What is your primary goal as an individual in attending Touchpoints training?
characters remaining
Where and how would you like to implement Touchpoints principles after the training?
characters remaining
How did you learn about this training?
Do you have any specific dietary needs?

Billing Information

*
(1) Please send invoice to:
- Personal Address
- Business Address
- Other
Other Billing Address (optional):
(2) If paying by credit card, please complete the registration form then call us at 857-218-4356 to provide credit card information.
(3) If paying by check, please complete the registration form and make check payable to Boston Children's Hospital. Include your name or invoice number on the check for easy reference. Mail check to Brazelton Touchpoints Center at the address provided below.

Payment

Payment Method

Pay By Check
Please make check payable to:
Boston Children's Hospital
c/o Brazelton Touchpoints Center
1295 Boylston Street
Suite 320
Boston, MA 02215

Payment Summary

Yes, I would like to receive news and updates

By checking this box, you're consenting to receive marketing emails from:
Brazelton Touchpoints Center/Brazelton Touchpoints Foundation, c/o Boston Children's Hospital, 1295 Boylston Street - BCH3111, Suite 320, Boston, MA 02215, United States
http://www.brazeltontouchpoints.org
You can revoke your consent to receive emails at any time by using the SafeUnsubscribe^TM link, found at the bottom of every email. Emails are serviced by Constant Contact.

Mobile View

Desktop View