Kellin, PLLC
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Dr. Kelly Graves
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Training Registration Form
*
Indicates required field
Which Training Are You Registering For?
*
Option 1
Option 2
Option 3
First Name
*
Last Name
*
Email Address
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Confirm Email Address
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Phone Number
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Agency or Organization (if applicable)
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Payment Method
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Pay by Check (See Instructions Below)
Pay Online (See Instructions Below)
Payment Method Instructions
Option 1: Pay by Check
(Check must be
received
in our office at least 1 week prior to the training to hold the spot)
Please make check payable to:
Kellin, PLLC
2110 Golden Gate Drive, Suite B
Greensboro, NC 27405
If you chose to pay by check, hit the "Submit Registration" button below. It will redirect you to an online payment page. Just close out of that browser if you plan on mailing a check.
Option 2: Pay Online
After you hit the "Submit Registration" button below, you will be automatically redirected to an online payment page.
Refunds will provided only if notified at least 24 hours prior to the event. All refunds will include a $20 processing fee. Returned checks will include a $25 return check fee.
By submitting my registration below, I am indicating that I understand the terms of this registration.
*
Yes
No
Submit Registration
Home
About
Dr. Kelly Graves
Our Associates
Clinical Services
Online Referral
Patient Portal
>
Forms
Online Payment
Fees and Insurance
Support Groups
Psychological Evaluations
Clinical Supervision and Consultation
Training and Speaking
Research
Corporate
Blog
Contact Us