NON-ACADEMIC INSTITUTE OR ORGANIZATION
SUBMISSION FORM
UNITED STATES AND CANADA
Please return the form to:
Tiane Corso Graziottin
adpcaweb@adpca.org
An institute or organization for this additional category may be a venue which runs
person-centered or experiential theoretical and/or practical programs, courses, workshops,
encounter groups, amongst others, without however offering academic credentials.
If the categories do not quite fit your context, please adapt them to wok for your situation.
Name of Institute/ Organization:
City/Town:
State/Province:
Country:
Name of Educational Activity(s):
Credential or Certification(s) Offered:
Contact Person(s):
Contact Person’s Phone:
Contact Person’s Email:
Website, if any:
Orientation of theoretical and/or practical activities (i.e., classical/client-centered,
focusing, emotion focused, child-centered play, p-c expressive, other, many. If other,
please explain):
Brief Description of person-centered aspects of the institute/organization: