Basic Workshop Registration

Basic Workshop - June 23, 24, 25, 2023 via Zoom!

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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Payment Level*

Basic Workshop - Member of FSCH - $375.00 USD

Basic Workshop - Non-Member - $460.00 USD

Basic Workshop - Graduate Students/Intern Members - $300.00 USD

Basic Workshop - Graduate Students/Intern Non-Members - $350.00 USD

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Total

$0.00 USD