SoR Psychodrama Registration & Donation Form 2026

Stages of Recovery Psychodrama Registration & Donation Form

Individual, Early-Bird, Group, Scholarship - see details below
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Personal information collected in this form is for the confidential use of the organizers only We don’t sell or share your personal data. We protect the personal information you entrust to us through the strong security measures implemented by the platforms we use.
Please join Center for Creative Action Strategies psychodramatists Jennifer Salimbene and Regina Sewall on the historic Moreno Stage at Boughton Place in Highland, NY, where we will embody and experience the Stages of Recovery model mapping the recovery journey across a lifetime. With sociometrist, recovery educator and coach, Ruth Riddick of Sobriety Together Training.

Based on the work of Kathleen O’Connell (author) and Phil Valentine (CCAR Recovery Coach Academy), with graphics by Ruth Riddick.

CONTINUING EDUCATION CREDITS | 12 hours
ABE & RTR Psychodrama
NYS social work credits through Prepared Training (+$25)
CARC/CRPA & CARC Electives through NYCB
NYS OASAS CE approval for CASAC / CPP / CPS
NYS mental health counselor credits (pending)

More information & next dates:
Please email Ruth Riddick, ruth@sobriety-together.com.
SECTION 1: ALL APPLICANTS
Are you registering on behalf of a group (5 minimum)? If so, on receipt of your registration fee, we will contact you for names of your group members.
Registrant Name

First NameLast Name
Email Address
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Contact Number
Please enter a mobile with text., if possibleFormat: (000) 000-0000.
City, State, Zip

Street Address

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Zip Code
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What is your primary profession (pick one):

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SECTION 2: PARTIAL SCHOLARSHIP APPLICANTS ONLY

through May 25, 2026
Thanks to the generosity of private donors, we are offering a limited number of partial scholarships on application to the event organizers who will determine eligibility. We will make every effort to accommodate as many applicants as possible. Award decisions are final and there will be no further correspondence.

Scholarship applications close on May 25, 2026. If successful, you will be issued a final invoice with details of your scholarship award before March May 31, with the payment balance due before June 3:

If your application is not successful, your deposit will be returned and your refund will be sent to the credit card used to make payment. If you do not respond to the scholarship offer by May 31, your deposit will be forfeit.

Incomplete applications for Partial Scholarship Awards will not be reviewed. Please include your Deposit payment before hitting the "submit" button below.
Please describe your interest in psychodrama and any experience with this modality. What, if anything, do you think is different about this training that sparks your interest:
Please describe the professional benefit you expect from this workshop - how will the experience benefit your clients, etc. The scholarships do not support personal recovery, although you may experience personal growth from doing this work:
Please describe the financial need prompting you to submit a scholarship application at this time. Please note that simply being badly paid in your job, while being a consideration, is not, in itself, a qualification for a partial scholarship:
Payment
This payment will appear as "Donnybrook Enterprises Inc." on your credit card statement.

Refund Policy
Mindful of the limits of the workshop space, we ask that you give notice of cancelation as early as possible so that we may offer your seat to the wait list.

2-4 weeks: Full refund minus a $50 administration fee to cover costs
1-2 weeks: 50% refund minus a $50 administration fee to cover costs
With less than two weeks notice: 50% refund minus a $50 administration fee to cover costs ONLY IF WE ARE ABLE TO FILL YOUR SPACE
24 hours: No refund

Refunds will be credited to the original form of payment. Click here to cancel a registration and claim a refund. Claims will be processed and refunds issued as soon as possible.

Fees (select all relevant products).

Stages of Recovery Workshop

$325.00 Quantity
Item subtotal:

Stages of Recovery Workshop

Group Registration

$1,450.00 Quantity
Item subtotal:

Donation towards Scholarships *

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$50.00 Quantity
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Donation towards Scholarships *

Please add details below (optional)

$25.00 Quantity
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Total

Please give the name of the person who supplied your coupon code, if applicable.
* Donation Instructions (optional): Please let us know if you have any special instructions for how you would like your generosity to be acknowledged - e.g. to support training for addiction professionals; to support training for psychodrama students; to support general scholarships. Please let us know if your donation is in honor or memory of someone important to you - i.e., "in memory of Sherie de Burgh."
Group Rates
Registering a group (minimum 5)? We will contact you on receipt of your registration for attendee details.
Payment Methods

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Contact Info

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Stages of Recovery Psychodrama Registration & Donation Form

SECTION 1: ALL APPLICANTS

SECTION 2: PARTIAL SCHOLARSHIP APPLICANTS ONLY

Payment

Fees (select all relevant products). *

Payment Methods

Fees (select all relevant products).