Registration Form The Iowa Board of Certification presents: “How To Facilitate Spiritual Wellness Without Being Offensive” Presenter: Braden Daniels, PhD, MHPSS July 18, 2014 9:00-Noon IBC Office 225 NW School St. – Ankeny, IA Full Name: ___________________________________________________________________ Organization: _________________________________________________________________ Address:_____________________________________________________________________ City: _________________________ State: __________ Zip/Postal Code: ______________ Telephone: (____)_____________ Fax: (____)_____________ Email: ____________________ Professional Credential: __________ How did you hear about this training? _______________ Training Description: It is largely accepted that Whole Health involves treating the body, mind and spirit. Unfortunately, oftentimes the spiritual piece is left unattended out of fear we might offend some. So how do we find room for this important piece without advocating for any particular belief system or ideology? Dr. Daniels has developed a guide which allows for healthy conversation involving spiritual matters while allowing the recipient to decide their own spiritual path. Training Cost: $40.00 (to be included with this registration form) Note: A $5.00 discount per training will be given when registering at the same time for both of Dr. Daniels’ trainings on July 18. Credit: Three (3) hours, Generic About the Presenter: Dr. Daniels is the author of the Iowa Peer Support Curriculum, also known as the “Iowa Model.” His work is recognized by the Iowa Board of Certification and is used to provide peer support training for certification throughout the state. Dr. Daniels holds a PhD in Religious Studies and is currently working on a second degree in Counseling. He has 10 years of experience n Handwriting Analysis which provides a personality profile which he uses in his counseling practice. In addition, he is a national speaker and advocate for those who struggle with mental health issues; his over 20 years of service‐oriented practices have provided him a wealth of experience concerning these matters. His works have been recognized and accepted by the Iowa Board of Certification, the National Director of Mental Health Services for Magellan, Iowa Vocational Rehabilitation and Iowa MHDS. Complete this registration form and mail it to the IBC office at 225 NW School St., Ankeny, Iowa – 50023, along with the $40.00 fee, or fax this form to the IBC office at 515‐965‐5540. Payment can be made with cash, check or Dwolla payment (available on the IBC website); once payment is received, or confirmation of Dwolla payment is confirmed, an email verification of registration for this training will be sent to you. Certificates of completion will be given to participants at the conclusion of the training. Cancellation Policy: Refunds are allowed 7 or more days before the training with notice of needing to cancel registration.