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ANXIETY

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 ANXIETY Powered By Docstoc
					             Registration Form
             (Duplicate this form if necessary.)
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      Register me for the following workshop:
       r Anxiety: An Inconspicuous
         Classroom Bully
             Thursday October 21, 2010                                                                                          HACC’s LANCASTER CAMPUS PRESENTS
             6:00 – 9:00 p.m.

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                                                                                                                            CLASSROOM SUPPORT FOR STUDENTS
Name

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School
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Address
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State                               Zip
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Phone                               Email

Registration Fee:
–––––––    Single registrant $25.00
–––––––    3 or more registering together from the
           same school $20.00 each registrant

Method of Payment:
o Check enclosed - payable to HACC

                                                                                                                        ANXIETY:
                                                                   HACC does not discriminate in employment,
o Visa                                                             student admissions, and student services on
o MasterCard                                                       the basis of race, color, religion, age, political
                                                                   affiliation or belief, sex, national origin,
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                                                                                                                        AN INCONSPICUOUS
Credit Card#                        Exp. Date                      ancestry, disability, place of birth, General
                                                                   Education Development Certification (GED),
––––––––––––––––––––––––––––––––––––––––––––––––––                 marital status, sexual orientation, gender
Name on Card
                                                                   identity or expression, veteran status, or           CLASSROOM BULLY
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Authorized Signature                                               any other legally protected classification.          _______________

Are there other topics that you would be interested in having us
                                                                                                                        2010/11
offer? Please indicate possible topics/dates/presenters below.                                                          Counselor Workshop
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                                                                                                                        Series Session #1
––––––––––––––––––––––––––––––––––––––––––––––––––                                                                      ACT 48 APPROVED NBCC APPROVED
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Tear off this registration form and send to:
    HACC -- Lancaster Campus
    1641 Old Philadelphia Pike
    Lancaster, PA 17602
    Attn: Peggy Andrews
                                   COUNSELOR
                                   Workshop Series
                                                   WORKSHOP #1
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                ANXIETY:                          ANXIETY:
                                           AN INCONSPICUOUS
An Inconspicuous Classroom Bully           CLASSROOM BULLY
                                    This workshop will provide a user-friendly focus
                                      on anxiety and its impact on the classroom.

                                        Thursday, October 21, 2010                     Mark your Calendar!
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                                             6:00 - 9:00 pm
                                        HACC’s Lancaster Campus
                                         Main Building Room 222                          March 24 and June 15
                                               Daniel J. Pezzulo, Ph.D                     are the scheduled
                                        School Psychologist & Psychotherapist
                                         Behavioral Health Care Consultants
                                                                                         dates for the next two
                                                                                       Counselor Workshop Series.
                                           TOPICS TO INCLUDE:
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                                       n    Neurological, biological and
                                            psychological components
                                            of anxiety
                                       n    Types of anxiety and the
                                            resulting impact upon the
                                            individual and the entire
                                            classroom
                                       n    Strategies for treating
                                            and coping with anxiety
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                                              Refreshments will be served.

				
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