Registration form : BioBasics
Registration is on a first-come/first-serve basis
(one form per course registration please)
ONCE COMPLETED CLICK ON SEND

Required fields
First Name :

Last Name :

Address :

City :

Province/State :

Country :

Postal code / Zone :

Email :

Phone 1 :

Phone 2 :

Fax :

Name of osteopathic college:

Date of graduation :

Desired phase


Are you bringing a treatment table?


Course Fee
 

The terms of payment will be sent upon reception of your registration


Payment information: Check or money order are accepted. We are unable to accept credit cards. A fee of 35$ will be charged on all returned checks.

CANCELLATION POLICY:
There will be a 250.00$ cancellation fee for cancellations made 30 days or less prior to a course.

Print this page