Register for the Getting the Love You Want Workshop

Please sign up for Getting the Love You Want by filling out the form below. Please be sure to provide correct information. If we are unable to confirm your information your spot might go to someone else.

Two Methods for easy registration,

1. Fill out the Registration Form, click “Send”, then submit payment via check sent to the address at the bottom of the page.

2. Fill out the Registration Form, click “Send”, then click “Buy Now” to visit Google Check Out and pay using a credit card.

First Name (required)

Last Name (required)

Partner's Name

Phone Number

Email Address(required)

Mailing Address (required for your workshop packet)

Street Line 1:(required)

Street Line 2:

City:(required)

State:(required)

ZIP:(required)

Payment Preference:(required)

  • Imago Certification Badge

    Couples Counseling and Therapy