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 May 2010 Workshop
Name: ____________________________________________________________________ Degree: ____________ License #: ______________________ State: _______________ Work or Mailing Address: ________________________________________________________
City: _____________________________________________________________________ State: _______ Zip Code:______________ Florida County:_____________________
Work Phone: _____________________ Home or Cell Phone:________________________
Fax: ______________________ E-Mail:__________________________________ Member of: FSCH _____ or ASCH ______ Neither ______
Neither ______ (please include documentation for ASCH) Student (school): ________________________________________________________________
(with proof of student status)If you register BEFORE APRIL 19, you may deduct $25 from either workshop,
or $50 from the Combined workshops.
Core Healing Advanced Combined May 13 & 14 May 15 & 16 May 13 - 16 Members of FSCH & ASCH ____ $285 ____ $285 ____ $495
____ $285 ____ $285 ____ $495 Non-members ____ $335 ____ $335 ____ $595
____ $335 ____ $595 Grad Student/Intern Members ____ $195 ____ $195 ____ $365
____ $195 ____ $195 ____ $365 Grad Student/Intern Non-Members ____ $245 ____ $245 ____ $465
____ $245 ____ $465 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.
