Transcript
2017 ISCA Fall Conference September 22-24, 2017 Renaissance Indianapolis North 11925 N. Meridian St, Carmel, IN 46032
1. Contact Information: Name
Clinic Name
Clinic Address
City, State Zip
Home Address
City, State Zip
Email
Clinic Phone
2. Registration:
Mobile Phone
(Please circle one option for a 4 hour session, for a 12 hour registration, please choose a 4 and an 8 hour session.) I will attend the Membership Luncheon on Saturday
Early Bird
After Sept 1
Complimentary
Complimentary
Gold & Silver Members
350.00
400.00
□ Yes
Members (in good standing)
400.00
450.00
□ No
Non Members
555.00
600.00
Early Bird
After Sept 1
Complimentary
Complimentary
Gold & Silver Members
230.00
280.00
Members (in good standing)
270.00
320.00
Non Members
395.00
445.00
Early Bird
After Sept 1
Complimentary
Complimentary
Gold & Silver Members
145.00
195.00
□ Yes
Members (in good standing)
165.00
215.00
□ No
Non Members
290.00
340.00
12 hour Full Conference Platinum Members
8 hour Full Conference Platinum Members
4 hour Full Conference Platinum Members
I will attend the Membership Luncheon on Saturday
□ Yes □ No
I will attend the Membership Luncheon on Saturday for an additional 35.00
CA: 4 & 8 hours
150.00
Lunch-additional 35.00
CA: 12 hours
200.00
Lunch-additional 35.00
Guest or Student (Not DC or CA)
100.00
Lunch-additional 35.00
Chiropractic X-Ray Class
975.00
Lunch-additional 35.00
Examinee Study Session and State Licensing Exam
450.00
Lunch-additional 35.00
3. Course Selections: (Circle selections required) Friday, 4:30 —8:30 pm
Saturday, 8 am – 12 pm
Saturday 2 pm—6 pm
Sunday 8 am—12 pm
Dr. David Kats Staying Professional While Benefiting from Search Engines and Social Media, Patient Education in the Electronic/Internet Age, Statistical Management of your Practice to Avoid Over utilization, Typical First and Second Day Procedures and Most Common Practice Violations and how to Avoid them Dr. Kurt Juergens Tools & Techniques for a Sports Chiropractic Practice- Part I Dr. Kurt Juergens Tools & Techniques for a Sports Chiropractic Practice- Part 2
Dr. Bart Green Integrated Health Systems- Part 1 Dr. Bart Green Integrated Health Systems- Part 2
Dr. David Kats Staying Professional While Benefiting from Search Engines and Social Media, Patient Education in the Electronic/Internet Age, Statistical Management of your Practice to Avoid Over utilization, Typical First and Second Day Procedures and Most Common Practice Violations and how to Avoid them
4. Payment Options: Mail registration form and check to the ISCA office at 150 West Market St., Suite 412 Indianapolis IN 46204 or complete credit card information below and fax to 317-870-1200 or email to
[email protected]. Register and pay with credit card online via the ISCA website, www.indianastatechiros.org.
Card Number Name on Card
Expiration Date Total Due All payment receipts will be emailed to the attendees’ email address given above.
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