AN INVITATION FROM THE

MANHATTAN PSYCHOLOGICAL ASSOCIATION

MANAGING THE CHALLENGES

OF

PATIENTS AND CAREPARTNERS

Workshop - Sign Up Now!

DATE: Sunday, 4 March 2012

TIME: 1:00 to 4:00 p.m.

LOCATION: Metropolitan Hospital, East 97^th Street and First Avenue

Presenters:

Dr. Richard Wexler, Dr. Suzanne Roff-Wexler, Dr. Rochelle Balter

and Dr. Herbert Gingo

Fee for Workshop

*2012 MPA members:        Free

*Non-Members:                 $40

Student Membership:       $15  

* Please note that the registration fee can be applied toward a first time membership or membership renewal

Schedule

1:00 PM Registration & Sign-In / Refreshments will be served

1:15 PM - 4:00 PM Workshop

Metropolitan Hospital / Draper Hall [east of Hospital] / 1918 First Ave., right side between 97^th & 99^th Streets

FDR Drive 96^th St. Exit / # 6 train to 96^th St / 96^th St. Cross-town bus / 1^st, 2^nd, 3^rd Ave buses

How to Register for the Workshop

Current MPA Members:

·         Send an email to Dr. James Rebeta at jlr2001@med.cornell.edu

Not an MPA member:

·         Fill out the registration form provided below

·         Mail form and check to Dr. James Rebeta at 450 East 63rd Street, #6B, New York, NY 10065

·         Send an email to Dr. James Rebeta at jlr2001@med.cornell.edu  stating you are a new member and will attend the workshop

Renewing your MPA membership:

·         Complete the membership application printed below and mail it, along with a check, to Dr. James Rebeta as listed here:

MANHATTAN PSYCHOLOGICAL ASSOCIATION
2012 Annual Dues Statement
January 1, 2012 – December 31, 2012

 __ I would like to attend the workshop – I do not wish to join MPA:        $40

__ I would like to join MPA and use the $40 toward my first year membership of $35

__ I would like to renew my MPA membership: $65 and I will attend for free

New Member /Associates:                                        $35                          
Member renewal                                                          $65
Students (Provide Copy of School ID):                 $15
Voluntary Contribution:                                                          
 

Total Enclosed:                                                                     

Name:                                                                                                                         
Degree:                                                                                                                                  
Address:                                                                                                                              

         
Is this your HOME or OFFICE address (circle one)?

E-mail Address:                                                                                         
 
Phone: (H)                         (W)                    (Cell)                                                  

         (Fax)                                         

Are you a NYSPA member? (Please circle)   Yes        No

Please submit your completed renewal form and check made payable to Manhattan Psychological Association to:
 
                   James L. Rebeta, PhD
                   450 E. 63^rd Street, Apt 6B
                    New York, NY 10065-7930