Advanced Workshop Registration

Intermediate/Advanced Workshop Registration

Name*

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Email*

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Address*

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City*

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State*

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Zipcode*

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Degree*

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License #*

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License State*

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Phone*

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I have previously taken an ASCH-approved Basic Workshop*

Yes

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Please Select Payment Level*

FSCH Member - $350.00 USD

New Life Members - $175.00 USD

Non-Member - $425.00 USD

FSCH Graduate Students/Intern Members - $275.00 USD

Graduate Students/Intern Non-Members (with student documentation) - $325.00 USD

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Total

$0.00 USD