Advanced Diagnosis and Nutrition in Practice Symposium 2010 Registration

July 16-18, 2010

You can register by phone:  888-393-0336, by fax: 704-845-8589, or by mail:

CDID Attn: Stacey Vastis PO BOX 2150 Matthews, NC 28106

  Discounts will not apply to rooms booked by telephone. 


Please copy & paste into Word document to print.  Thank you

You must be a CDID & ACA member to apply for Member rates!!!  

 

  
 American Academy of Chiropractic Physicians (AACP)

Council on Diagnosis and Internal Disorders - ACA (CDID_ACC) $455 x _____

Non Members Registration Rate:                                              $495 x _____



Spouse, Students, and Office Staff                                     $110x _____

(Includes banquet and two lunches) Please print name(s):______________________________________ 
Additional Banquet Tickets $65 each (1 free banquet ticket with each paid Doctors registration)                                                                      $65 x _______

AACP Annual Dues* (Due 7/1/10)                                          $150 x ______

CDID-ACA Annual Dues* (Due 7/1/10)                                   $120 x ______
 If you are a member of 2009-2010, your membership will expire 6/30/10.  Please renew your membership with your registration to be eligible for the member discount. 

                                                                               GRAND TOTAL $ ______

* Membership dues to the American Academy of Chiropractic Physicians or the Council on Diagnosis and Internal Disorders-ACA will include free annual subscription to Holistic Primary Care and The Original Internist and free membership updates.
Symposium 2010 Cancellations after June 30, 2010 are subject to a 50% cancellation fee.

(Please make sure to print information CAREFULLY.  The information listed below is what is listed on our website.)

Name and Degrees:_______________________________________________________________

Address: _________________________________________________________________________

City: ___________________________ State: ______________ Zip: _________

Phone: (_____) ___________              E-Mail: ________________________

Website: __________________________

Method of Payment:    Check (Please make check out to CDID)   Visa    MasterCard

Credit Card Number: _______________________________ Expires: ___________

Three digit security code: _______

Signature: ___________________ Amount Enclosed (charge amount): $________