2023 Kentucky Mandated Trainings–Registration Form CompanyThis field is for validation purposes and should be left unchanged.Full Name of Person attending the training:* First Last License/Credentials*Occupation*Agency or School*Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email* Name of Person completing this form if different from attendee First Last Email of Person Completing this form–if different from Person Attending the Training. (If you're registering more than one person–please add each person's name and email and which trainings they will be attending to the "Special Accommodations" box. Thank you. Understanding Suicide–What Mental Health Professionals Need to Know About Assessing and Managing Suicide Risk ($125.00) April 24, 2026 (9:00 AM – 4:00 PM) *Understanding Suicide Training* ZOOM *$125.00 September 24, 2026 (9:00 AM – 4:00 PM) *Understanding Suicide Training* ZOOM *$125.00 6 Hour CE Class Suicide Assessment and Treatment. Board Approval Pending for KY LPC, MFT, SW, and Psych *Meets Mandatory Suicide training Requirement* **Provided Live via Zoom**Domestic Violence for Mental Health Professionals ($65.00) April 23, 2026 (9:00 AM – 12:00 PM) *Domestic Violence Training* ZOOM *$65.00 September 25, 2026 (9:00 AM – 12:00 PM) *Domestic Violence Training* ZOOM *$65.00 3 Hour CE Class Domestic Violence Board Approval Pending for KY LPC, MFT, SW, and Psych *Meets Mandatory Domestic Violence training Requirement* **Provided Live via Zoom**LPC Law ($65.00) April 23, 2026 (1:30 PM – 4:30 PM) *LPC Law Training* ZOOM *$65.00 September 25, 2026 (1:30 PM – 4:30 PM) *LPC Law Training* ZOOM *$65.00 3 Hour CE Class LPC Law Board Approval Pending for KY LPC, MFT, SW, and Psych *Meets Mandatory LPC Law training Requirement* **Provided Live via Zoom**MFT Ethics (Including 2 hours of Telehealth Ethics) ($65.00) May 14, 2026 (9:00 AM – 12:00 PM) *MFT Ethics (Including 2 hours of Telehealth Ethics) Training* ZOOM *$65.00 October 30, 2026 (9:00 AM – 12:00 PM) *MFT Ethics (Including 2 hours of Telehealth Ethics) Training* ZOOM *$65.00 3 Hour CE Class MFT Ethics (Including 2 hours of Telehealth Ethics) Board Approval Pending for KY LPC, MFT, SW, and Psych *Meets Mandatory MFT Ethics and 2 hour MFT Telehealth Ethics* **Provided Live via Zoom**Trauma-Informed Practice for Mental Health Professionals Working with Children & Adolescents ($125.00) July 17, 2026 (9:00 AM – 4:00 PM) *Trauma-Informed Practice for Mental Health Professionals Working with Children & Adolescents Training* ZOOM *$125.00 6 Hour CE Class Trauma-Informed Practice for Mental Health Professionals Working with Children & Adolescents Board Approval Pending for KY LPC, MFT, SW, and Psych **Provided Live via Zoom**Practical Legal Tips for Mental Health Professionals ($125.00) October 23, 2026 (9:00 AM – 4:00 PM) *Practical Legal Tips for Mental Health Professionals Training* ZOOM *$125.00 6 Hour CE Class Practical Legal Tips for Mental Health Professionals Board Approval Pending for KY LPC, MFT, SW, and Psych **Provided Live via Zoom**Play Therapy 101 ($125.00) November 12, 2026 (9:00 AM – 4:30 PM) *Play Therapy 101 Training* In-Person (Elizabethtown, KY)*$125.00 6 Hour CE Class Play Therapy 101 APT Approved Provider 20-599 Board Approval Pending for KY LPC, MFT, SW, and Psych **Provided In-Person–Elizabethtown, KY**Sand Therapy for Beginners ($125.00) November 13, 2026 (9:00 AM – 4:30 PM) *Sand Therapy for Beginners Training* In-Person (Elizabethtown, KY)*$125.00 6 Hour CE Class Sand Therapy for Beginners APT Approved Provider 20-599 Board Approval Pending for KY LPC, MFT, SW, and Psych **Provided In-Person–Elizabethtown, KY**Trauma-Informed Play Therapy Interventions ($250.00) May 21 & 22, 2026 (9:00 AM – 4:30 PM) *Sand Therapy for Beginners Training* In-Person (Elizabethtown, KY)*$125.00 12 Hour CE Class Trauma-Informed Play Therapy Interventions APT Approved Provider 20-599 Board Approval Pending for KY LPC, MFT, SW, and Psych **Provided In-Person–Elizabethtown, KY**Continuing Education needed (you may choose more than one): Counseling Marriage and Family Therapist Psychology Social Work N/A – I’m a Student Other If other, please list here*Any special accommodations or anything else you would like us to know?Total Cost of Registration: $0.00 May we add you to our mailing list so you can be updated on other upcoming trainings and happenings at Brighter Futures Counseling?* Yes, please! No, thanks. Please read our Cancellation Policy and confirm you've read and understand.*Cancellation Policy I have read and understand the cancellation policy. Name as it Appears on the Credit Card* First Last Credit CardCard Details Cardholder Name