TEXAS SOCIETY OF HOMEOPATHY
2010 ANNUAL CONFERENCE REGISTRATION FORM
Please register online or by mail- w/Ck or CC Payment
NAME(S): ____________________________________________
PHONE: ___________________
ADDRESS:_______________________________________
CITY _______________________________ EMAIL: ___________________________
STATE: ________________ ZIP: _____________________
_____ FIRST AID COURSE $ 50 ______
_____ FRIDAY EVENING Only 50 ______
_____ SAT -Lt breakfast & break Only 115 ______
_____ Sunday Only 50 ______
_____ FRI/SAT/SUN - Lt breakfast & break 175 ______
_____ TSH 2009-2010 DUES- Become A Member 25 ______
_____ DONATION: TAX DEDUCTIBLE ______
_____ Melvyn Smith Scholarship Fund ______
TOTAL ENCLOSED $__________
PLEASE REGISTER BY Sept 1st, so that we may prepare for your attendance!
Register through PAYPAL on-line at Texassocietyofhomeopathy.com
Or by Check Payable to: Texas Society of Homeopathy
Mail Registration Form & Payment To:
Maureen Hanson
5754 Glenwillow Ct
Fort Worth, TX 76132
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