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Music Therapy Assessment Tool for Awareness in
Disorders of Consciousness

First Level Training





First Name*

Last Name*
Home Phone*
Cell Phone*
Mailing address*

Current Position
Current Institution
If student, year of graduation


Please review your responses before clicking "Submit." Upon submission, your information will be sent to Girard Kratz, Registrar at Temple Music Prep, who will provide you with instructions for immediate payment of the non-refundable $35 registration fee. Registration is considered complete only after total payment is secured. Registration Deadline is April 28, 2014. There is a $50 late registration fee for any payments received after April 28, 2014.

Registration questions, please email Girard Kratz.