Basic Registration

Basic Hypnosis with Applications

FSCH Master Teachers

20 CEU's available

To register, please print and fill out this form, and send it along with your check to:

FSCH, at 8227 SW 82 Place., Miami, FL 33143. If you have any questions please call 305-598-9992.

If you would rather pay your tuition online, please print and send this page, but use the Paypal buttons at the bottom of this page to pay the fee. Paypal is the only way we can accept credit cards.

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Registration for April 2012 Workshop

Name: ____________________________________________________________________

Degree: ____________ License #, if applicable: ______________________

Work or Mailing Address: ________________________________________________________

City: _____________________________________________________________________

State: _______ Zip Code:______________ Florida County:____________________

Home or Cell Phone:______________________ E-Mail:____________________________________

(please print clearly)

Student (school): ___________________________________________________________

(send proof of student status with registraton)

Registrations received before March 23 are entitled to take

the Early Registration fee

Early RegistrationRegular Registration

FSCH Members ___ $325___ $360

Non-Members ___ $375___ $410

Grad Student/Intern Members ___ $255___ $290

Grad Student/Intern Non-Members ___ $280___ $315

Please print this form, and send along with fee, to:

FSCH, 8227 SW 82 Place, Miami, FL 33143

or, to pay online, using a credit card, please use the appropriate Paypal button below.

Please note: you will still have to print and fill in the above form, and send it,

along with any necessary documentation, to the above address.

Registration will NOT be complete until we have received this printed form.

(And it will only print properly from Internet Explorer, not AOL or Mozilla -- sorry.)

The Charles and Elaine Mutter Foundation funds workshop tuitions for a limited number of

student member attendees with financial needs, up to 40% of tuition.

Call Diane, at 305-598-9992, for more information.

If you'd like to join FSCH, please print and fill out the membership application on this site,

and include it along with your separate membership fee, a copy of your license,

and your workshop registration fee with this printed form.

Please send fees and appropriate documentation to:

FSCH, 8227 SW 82 Place, Miami, FL 33143