2026 NCTS East Registration

May 11, 2026

8:30am (Breakfast) to 4:00PM

Loyola Retreat Center
161 James Street
Morristown, NJ 07960

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Name *

First

Last

Email *

Phone *

Address *

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City

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Zip Code

Are you a member of a CPSP Chapter? *

• Yes
• No

Chapter *

Are you Board Certified with CPSP and/or are you a CPSP Diplomate? *

• Yes
• No

What certifications do you hold with CPSP? (Check all that apply.) *

• Clinically Trained Minister
• Associate Clinical Chaplain / Pastoral Counselor
• Clinical Chaplain / Pastoral Counselor
• Pastoral Psychotherapist
• Associate Hospice and Palliative Care Subspecialty
• Hospice and Palliative Care Subspecialty
• Substance Use and Addiction Subspecialty
• Diplomate in Pastoral Supervision
• Diplomate in Pastoral Psychotherapy

Are you currently a CPE Trainee? *

• Yes
• No

Are you currently a CPE Supervisor in Training? *

• Yes
• No

Who is your CPE Training Supervisor? *

If you are training in a CPSP Accredited Training Center, what is the name of your center?

Is this your first time attending a CPSP National Clinical Training Seminar? *

• Yes
• No

Meal Choice (if available) *

• Regular
• Vegetarian
• Kosher
• Halal Vegan

Registration Fee

Price: $95.00

Payment *

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