RegistrationStep 1 of 425%You will select the course(s) or group(s) you wish to register for on Step 4 of the Registration form.Name(Required) First Last Email(Required) PhoneAddress(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Professional Background(Required)Please select the option(s) that best describes your professional background/work experience, or enter your own description on the line provided. No specific professional background or experience is required; this information helps us tailor the course to our participant groups and set up corresponding records for CLE and CE credit, where applicable. Attorney Legal Field, Non-Attorney (Paralegal, Legal Assistant, LDP, Office Manager, etc.) Mental Health Professional (MFT, LCSW, LPCC, LPC, etc.) Financial Professional (CDFA, CPA, CFA, etc.) Coach (Divorce Coach, Conflict Coach, etc.) MediatorOther Professional ExperienceAre you a California-licensed attorney? (For CLE recordkeeping purposes – Attorneys licensed in other states should check No) * Yes NoAre you a California-licensed LMFT, LCSW, LPCC, or LEP? (For CE recordkeeping purposes – Professionals licensed in other states should check No) Yes NoFor California-licensed professionals: please provide your CA Bar Number (attorneys) or License Number (LMFT, LCSW, LPCC, LEP)Secondary EmailIn the event that your email security/spam filter prevents our communications from reaching your inbox, a secondary email will allow us to contact you with course information until the issue can be corrected. How did you hear about the program you are registering for?Please let us know how you found us! LinkedIn Mosten Mediation Training Email Acquainted with Woody Referral from Colleague/Friend Organization Calendar Google Search Instagram OtherRecording Information and Release We record all trainings for internal use and development, and we sometimes use screenshots or training segments for marketing. Recordings are not available to participants and are not distributed publicly except as described. Small group breakout room exercises are not recorded during the training. If you have any questions regarding the recording release, please contact brianna@mostenmediationtraining.com.Recording Notification and Consent(Required)By executing this form and participating in the Mosten Guthrie Training or Group, you hereby acknowledge and consent to the recording and distribution of reproduction(s) of your voice and image as a participant in the training program. You hereby acknowledge that Mosten Guthrie Academy is the sole owner of all rights in and to the training program, and the recording(s) thereof, for all purposes; and that Mosten Guthrie Academy has the unfettered right, among other things, to use and distribute the recording(s) of the training program, or any portion thereof, and your video and/or audio as embodied therein, together with your name, professional information, photograph or likeness (including, without limitation, any photographs or other material provided by you). I acknowledge that I have read and agree to the aboveCourse Selections and Payment40-Hour Mediation TrainingPlease select course(s) to enroll 40-Hour Family & Divorce Mediation Training *Early Bird (Sept 2026)Building a Successful Mediation PracticeThis field is hidden when viewing the formPlease select training to enroll Building a Successful Mediation Practice (April 2-3, 2026)Advanced Mediation TrainingPlease select training to enroll Advanced Family Mediation Training and Practicum *Early Bird Advanced Family Mediation Training Only (May 6-7, 2027) *Early Bird Practicum Only (May 14, 2027)Advanced Collaborative TrainingPlease select training to enroll Advanced Collaborative Training *Early Bird (Dec 3-4, 2026)Master ClassPlease select training to enroll Master Class (Nov 12-13, 2026)Open MicThis field is hidden when viewing the formPlease select group(s) to enroll Open Mic Event (Free) – Feb 6, 2026Training Price: Total Coupon Payment Method – Click on PayPal button to pay using PayPal account OR credit card/bank account (option displays on next screen)PayPal CheckoutCredit CardMasterCardVisaSupported Credit Cards: MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name Δ