Registration

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.

Please see Workshop Announcement for information about the hotel and workshop location. 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.

Registration for October 2008 Workshop

Name: __________________________________________________________

Degree: _________ License #: ___________________ State: ___________

Work or Mailing Address: ______________________________________________

City: ___________________________________________________________

State: _______ Zip Code:_______________ County:____________________

Work Phone: _____________________ Home or Cell Phone:________________________

Fax: ______________________ E-Mail:______________________________

Member of: FSCH _____ or ASCH ______ Neither ______

(please include documentation for ASCH)

Student (school): ___________________________________________________________

(with letter from faculty documenting student status)

For registrations received prior to September 23, you may take an Early Bird Discount!

Subtract $25 from either the Basic or Advanced fee, or $40 from the Combined rate.

Basic Advanced Combined

October 23 & 24 October 25 & 26 October 23-26

Members of FSCH & ASCH ____ $295 ____ $285____ $540

Non-members ____ $345 ____ $335____ $640

Grad Student/Intern Members ____ $220 ____ $220 ____ $430

Grad Student/Intern Non-Members ____ $240 ____ $235 ____ $460

The Charles and Elaine Mutter Foundation funds workshop tuitions for 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

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.