Course Registration Form Mark the course(s) that you would like to attend.
Please print and complete fully, one form per attendee.
FAX: 818-789-3456
MAIL: 17939 Chatsworth St # 254, Granada Hills, CA 91344
Registration Special for New Attendees - Receive $100 off the 4-Day Neurofeedback in a Clinical Practice course when full payment of 4-Day course fees is received 30 days in advance. This offer is for new 4-Day course attendees only.
O Neurofeedback in a Clinical Practice - Southern CA May 19 - 22, 2011 • Price: $1095 O Neurofeedback in a Clinical Practice - Chicago, IL April 14 - 17, 2011 • Price: $1095 O Neurofeedback in a Clinical Practice - Arlington, VA March 17 - 20, 2011 • Price: $1095 O Neurofeedback in a Clinical Practice - Orlando, FL February 24 - 27, 2011 • Price: $1095 O Clinical Interchange Conference - Chicago, IL April 29 - May 1, 2011 • Price: $845
PLEASE PRINT
Name:
Institution:
Address:
Title/Degree:
License
#:
Field
of Practice:
Home
Phone:
Business
Phone/Ext:
Fax:
Email:
How did you
hear about our professional Courses? (please include name if referred by an individual)
Attendees are responsible for their own lodging and meals which are not included in the registration fee. Hotel information will be sent to you upon receipt of registration. Please make your reservations early. Request hotel rates offered for "EEGER course attendees"; availability and special room rates are subject to limitations.
REFUND POLICY FOR ALL COURSES: If cancellation notification is received at least 30 days prior to the workshop, a non-refundable processing fee of $195.00 is charged. If cancellation notification is received less than 30 days before the workshop, there is no refund of course fees. A qualified substitute may attend in your place if you are unable to attend.
If registration is received less than 10 days prior to course date, manual may not be available at the course.
This didactic education program is accredited by BCIA (4-Day Neurofeedback in a Clinical Practice Course Only). Call for details.
