The Birth Scene

99 cong. registration

9th International Congress of APPPAH
December 3-6, 1999
San Francisco, California

Registration Form
Please print-out and fill-in

Name____________________________________________________
Position___________________________________________________
Address__________________________________________________
City_________________State________Country___________________
Zip/Postal Code____________________
Phone_____________Fax______________
Email:__________________________________

Membership, Congress, Workshops and CE Fees
Admission Fees
Congress : Member and Non-Member
$330 / $370

Pre & Post Congress Workshops
1-day workshop $110 / $150
2-day workshop $220 / $260

1 day workshops
Please check the workshop you wish to attend.
Dec. 2: Weaver & Clark ___
Dec. 3: Levy __, Mandel __, or Solter __
Dec. 6: Baker __ Wilcox/Hammond __, or Pearce __
Dec. 7: Castellino___or Turner/Barajon___

2 day workshop:
Please check the workshop you wish to attend.
Dec. 2-3:
Hendricks & Hendricks ______

Membership Fees
One Year/Three years
N & S America $75 / $180
International $100 / $240
Student (U.S. only) $50 N/A

CEU Certificate(s)
Processing fee $25 per certificate

Caitlin Hicks "Singing the Bones"
Extra tickets for those not registered for the congress are $15 if ordered before Nov. 15; $25 at the door.
The performance is on Sunday night 8-9:30, followed by light refreshments.

Please Complete This Summary
Pre & Post Congress Workshops (choose) $ ____________
CE certificate(s) fee total $____________
List state and professional licenses________________________________________________

Membership Fee (optional) $ _________
Congress Fee $ _________

For the General Fund $ ________
For the Verny Award $ ________

For the Cheek Memorial Lecture $ _______
Total Enclosed (US Funds only) $ _______

Please make your check payable to APPPAH.
Credit Card Information (Visa/MC only)
Card Number ________________________________Exp. Date:____
Your Signature_____________________________________________

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Congress Index

Membership, Congress, Workshops and CE Fees
Admission Fees Congress : Member and Non-Member $330 / $370
Pre & Post Congress Workshops 1-day workshop $110 / $150 2-day workshop $220 / $260
1 day workshops Please check the workshop you wish to attend. Dec. 2: Weaver & Clark ___ Dec. 3: Levy __, Mandel __, or Solter __ Dec. 6: Baker __ Wilcox/Hammond __, or Pearce __ Dec. 7: Castellino___or Turner/Barajon___	2 day workshop: Please check the workshop you wish to attend. Dec. 2-3: Hendricks & Hendricks ______
Membership Fees One Year/Three years N & S America $75 / $180 International $100 / $240 Student (U.S. only) $50 N/A	CEU Certificate(s) Processing fee $25 per certificate
Caitlin Hicks "Singing the Bones" Extra tickets for those not registered for the congress are $15 if ordered before Nov. 15; $25 at the door. The performance is on Sunday night 8-9:30, followed by light refreshments.