Application Form:


Name__________________________________________ Degree___________________

Affiliation (If applicable)_____________________________________________

Address_________________________________________________________________

________________________________________________________________________

City, State, Zip________________________________________________________

Phone: _______________________________________ Fax______________________

E-Mail__________________________________________________________________

Audiotapes of SSTI Annual Meetings are available in boxed sets of 12
cassettes: $140 for non-members, $120 for SSTI Members (shipping &
handling included).

___I can't attend this year. Please send audio cassettes of the 2000
   Colloquium.

___I missed the 1993 meeting "Toward a New Psychotherapy."
   Please send the album. 

___I missed the 1994 meeting "The Experience and Expression of Anger."
   Please send the album.

___I missed the 1995 meeting "Affect, Script and Psychotherapy."
   Please send the album.

___I missed the 1996 meeting "The When, When Not, and How of Brief
   Psychotherapy." Please send the album.

___I missed the 1998 meeting "The Philadelphia System: Affect and Script
   in Psychotherapy."  Please send the album.

___I missed the 1999 meeting "The Experience and Relief of Distress:
   Overload, Grief, and Suffering." Please send the album.


Conference Tapes                                         $______________

Please enroll me as a member of the Tomkins Institute __ $ 45 

Thursday Review Lecture ________________________________ $______________

Conference Registration ________________________________ $______________


                                                  Total: $______________


Check Enclosed_________________________ Please charge my MasterCard/VISA

Card Number ____________________________________ Exp. Date _____________


Signature (Absolutely necessary)________________________________________


Please send payment and completed application to:

Tomkins Institute Conference
255 South 17th Street (Suite 2403)
Philadelphia, PA 19103-6224

1-800-317-1669
Philadelphia and suburbs please call 1-215-546-1853 


www.behavior.net/orgs/ssti - julief@tomkins.org