Registration Form

The Wellspring Review Helping Counselors Since 1987

Making Licensure Dreams A Reality

Registration Form

Print this form, and mail to:
The Wellspring Review, 1132 West Blanco, San Antonio, Texas 78232

Or fax to 210-492-2630.Or by telephone 1-800-898-9393. Or visit our SHOP page to register or order on-line.

We accept checks, money orders, Visa, MasterCard, American Express, and Discover.

Name _____________________________________________
Address ___________________________________________
__________________________________________________
Email: ____________________________________________
Telephone _________________________________________

All courses are held on a Saturday, 9:30-5:30/6 (depending questions).
I will attend the following 2008/09 Wellspring Review: (Please circle date.)

Austin    December 20    February 7    April 4

Dallas/Fort Worth     December 13    February 28    April 18

Houston    November 15    January 24    March 7

San Antonio    November 22    January 17    May 23

___ $295 Review includes text, 750-question CD, and personalized instruction.
___ $95 Refresher course ($145 with purchase of new text; $185 for text & CD) Need to provide date of previous Wellspring course attended

Available for Separate Purchase (Prices include sales tax )

___ $75 The Wellspring Review Text, copyright 2007
___ $15 LPC-Intern Handbook
___ $55 750-question CD for LPC Exam, NCE & PCLE copyright 2005
___ $50 100-question Research & Statistics Tutorial CD, copyright 2004
___ $80 Flash Card Set (10 Flip Books)

Shipping and Handling

___ $ 15 Text or text & any or all other item; Flash Card Set
___ $ 10 CD or CDs and LPC-Intern Handbook (Handbook for Texas only)

_______ TOTAL
Prices are in effect for the above reviews and materials as of January 15, 2008. Prices may change without notice.

VISA, MC, AMEX or Discover # _________________________________

Expiration Date _____________________________________________
Signature __________________________________________________

Return Policy You may purchase merchandise from this Web site by using any one of the payment options listed.The Wellspring Review reserves the right to change its payment procedures at any time without prior notice to you. No credit will be issued for registering to take one of our live instruction courses if you do not attend. However, you will be offered a spot at a future course offered within 12 months of the original course date with no other fees, regardless of possible increases in course costs or updates to materials.