Registration Form

The Wellspring Review
Products & Services for Counselor Licensure Since 1987

Making Licensure Dreams A Reality

Registration Form

Download 2012 Registration & Order Form OR Print this page and mail to:
The Wellspring Review, 1122 West Blanco, San Antonio, Texas 78232

Or fax to 210-492-2630.Or by telephone 210-490-4540.

Or visit our SHOP page to register or order on-line.

We accept checks, money orders, Visa, MasterCard, American Express, and Discover.

Name _____________________________________________
Address ___________________________________________
__________________________________________________
Email: ____________________________________________
Telephone _________________________________________

All courses are held on a Saturday, 9:30-5:30/6 (depending on class questions).
I will attend the following Wellspring Review: (Please circle date.)

Austin:

April 14   June 9

Dallas/Ft Worth:

February 18      April 21      July 14      October 13

Houston:

January 14      March 31      June 23      September 22      November 17

San Antonio:

February 4     May 19      August 25      November 10

Visit our Course Location page for review course site address, phone number, and web site link for driving direction information.

___ $295 Study Course includes text, over 100 practice questions, and personalized instruction.

___ $95 Refresher Course - if already attended Study Course & want to re-attend for any reason ($145 with purchase of new text) NOTE: Need to provide date of previous Wellspring course attended to get this rate.

Available for Separate Purchase (Prices include sales tax )

___ $75 The Wellspring Study Guide for the NCE, copyright 2010/2011
___ $80 Flash Card Set (10 Flip Books), copyright 2009

Shipping and Handling (USPS Priority Mail. Call for other options & pricing)

___ $ 15 Text or text & any or all other item
___ $ 10 Flash Card Set

_______ TOTAL
Prices are in effect for the above courses and materials as of August, 2011. Prices may change without notice.

VISA, MC, AMEX or Discover # _________________________________

Expiration Date _____________________________________________
Signature __________________________________________________

Return Policy No refunds or returns permitted. Materials are copyrighted. You may purchase merchandise from this Web site by using any one of the payment options listed.The Wellspring Review reserves the right to change its payment procedures at any time without prior notice to you. No credit will be issued for registering to take one of our live instruction courses if you do not attend. However, you will be offered a spot at a future course offered within 12 months of the original course date with no other fees, regardless of possible increases in course costs or updates to materials.