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REGISTRATION FORM
REGISTER NOW TO RESERVE YOUR PLACE - Space is Limited - Discounts for 2 or more registrants.
WHERE: Center for Neuroacoustic Research
One Carlsbad Research Center 2382 Faraday Ave Ste 250 #23-24 Carlsbad CA 92008-7262
WHEN: March 10-11, 2012 (2 day only)
TIME: Registration: 9:30-9:50 AM on Saturday. Seminar hrs: Sat: 10AM-5:00PM – Sun:10AM-4:00
WHO WILL BENEFIT FROM ATTENDING?
DCs, MDs, RNs, LCSWs, PhDs, Massage & Energy Therapists,Parents,YOU
Name__________________________Degree_______ License#________
Address___________________________________________________
City____________________ State/Province_____________ Zip________
Phone____________________E-mail______________________
Save ~ Save with Early Registration - Postmarked by Feb 10, 2012 -- Only $265
TUITION: Postmarked: By Feb 10 By Mar 1 After Mar 1
Registrant & $265 $295 $375
5 or more registering together $215 $245 $300
Current Full time Student (ID required w/ Registration) $215 $245 $300
Patient at CNR (Within last 2 yrs) $200 $245 $300
Spouse: Name___________________ $215 $245 $300
–CEU Certificate – Add $10.00 ___________________
Registration is refundable (minus a $40 administrative fee) when canceled in writing prior to 14 days of the Seminar. Admission at the door - $400 if there is space.
IF PAYING BY CHECK, make payable and mail to CENTER FOR NEUROACOUSTIC RESEARCH (See Below)
IF PAYING BY PERSONAL CREDIT CARD, mail or fax (760-729-0881) this signed form: M/C Visa
CC#:__ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ Exp.:__ __/__ __ CVV______
Billing Address: _____________________________________________________________
Signature: __________________________________ Today’s Date: ______________
CNR reserves the right to cancel the Seminar due to circumstances beyond its control. Such circumstances may include, but are not limited to acts of God, military action, a presenter illness, and in a very rare occasion, insufficient participants. In the event of such a circumstance and decision, the extent of CNR’s liability and that of any person associated with CNR, shall not exceed the amount paid by a participant. A complete deposit refund will be made to each respective participant.
CENTER FOR NEUROACOUSTIC RESEARCH
One Carlsbad Research Center 2382 Faraday Ave Ste 250 #23-24 Carlsbad CA 92008-7262
Tel: (760) 931-5333 Fax: (760) 729-0881
E-mail: cnr@neuroacoustic.com Website: www.neuroacoustic.com
WHAT OTHERS SAY…
“Dr. Thompson’s understanding of the relationships between sound, body and mind, and between audio, vibration, and nervous systems is exceptional. The process, protocols and equipment…for the positive re-alignment of people who experience the effects of his vibroacoustics.” Frank S, Researcher & Seminar Attendee
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