Registration LDA Parent, Care Provider & Professionals Registration Name* First Last Email Address* Phone Number*Home Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Program Name*Select a programThrough the Eyes of a ChildUnderstanding Social DevelopmentChallenging BehavioursWorry, Stress and AnxietyAlpha ChildrenReading Challenges: Assessment & Multi-Sensory ApproachesAggression and Self ControlAttention Challenges and Self RegulationCounterwillAdolescenceParent Support GroupIndividual ConsultationsDo you require a professional development certificate?* Yes No Through the Eyes of a Child Price: Understanding Social Development Price: Worry, Stress and Anxiety Program Fee Price: Alpha Children Program Fee Price: Reading Challenges: Assessment & Multi-Sensory Approaches Program Fee Price: Aggression and Self Control Program Fee Price: Attention Challenges and Self Regulation Program Fee Price: Counterwill Program Fee Price: Adolescence Program Fee Price: Parent Support Group Fee Price: Individual Consultation Fee Price: Please contact info@ldasvi.bc.ca to schedule an appointment for your individual consultationTotal $ 0.00 CAD Section BreakCheckout*PayPal Checkout MasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name CommentsThis field is for validation purposes and should be left unchanged.