Registration form for “Registered Behavior Technician Training” As reported by the Behavior Analyst Certification Board (BACB), the BACB will start taking application for the new credential, Registered Behavior Technician (RBT) sometime this year (2014). We are pleased to offer the required 40-‐hour training for providers of behavior services to qualify for this new credential. For information on the RBT credential, go to www.bacb.com. The objectives for this training are the tasks as set forth in the BACB Registered Behavior Technician Task List on the following core areas: • Measurement • Assessment • Skill Acquisition • Behavior Reduction • Documentation and Reporting • Professional Conduct & Scope of Practice Dates : 8/25/2014-‐9/5/2014 Location: 14074 Trade Center Drive-‐Conference Room 2 Fishers, IN 46038 Time: Monday-‐Friday (each week) 4:00-‐8:30pm Cost: $360 Deadline to register: 3/14/2014 Directions: 1. Print out this document. 2. Fill in all fields. a. Note: If registering multiple staff, please fill out one form per attendee. 3. Mail the completed form and check or money order to: a. [email protected] or b. Conference Registration Conduct Curb 14074 Trade Center Drive Fishers, IN 46038 Attendee Information (One form per attendee) Name: Title/Position: Phone: Email: Agency Name & Address: Billing Address: Cancellation Policy: Registration substitution is not permitted. Cancellations of confirmed registrants must be in writing and received by Conduct Curb at least 2 weeks prior to the first day of the event; approved cancellations will incur a minimum administrative fee of $25. No-‐shows will be responsible for the entire registration fee. Conduct Curb reserves the right to cancel any training event if minimum attendance requirement are not fulfilled. Conduct Curb is proud to offer Type 2 continuing education units through Dr. Gwen Martin (an approved ACE provider). One continuing education unit (CEU) equates to a 50-‐minute presentation that meets the BACB guidelines and is included in your registration fee. For more information on CEUs, please go to www.bacb.com. If you have any concerns regarding presentations or trainings hosted by Conduct Curb, LLC or CEUs gleaned from presentation presented by Dr. Gwen Martin, please contact us at [email protected] to lodge a complaint.