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Please send one form for each course.
Course
Semester: [ ] Fall [ ] Winter Site: Name Address Occupation Phone (Day) (Evening) Membership Status in MPC [ ] Member [ ] Request for Membership Training Program Status in MPC [ ] Candidate You may send your registration forms to either: Suanne Zager, MSW, CSW, BCD Jeffrey Glindmeyer, Ed.D. Co-Chair, Psychoanalytic Study Program Co-Chair, Psychoanalytic Study Program 518 LaSalle Blvd. 4031 W. Main St. Ste. 300, P. O. Box 19155 Lansing, MI 48912-4222 Kalamazoo, MI 49019-0155
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