NYCTCM New York College of Traditional Chinese Medicine

NYCTCM New York College of Traditional Chinese Medicine Continuing Education Program Registration Form Name: Address: City: State: Zip Home Tel: Business Tel: Email: Profession: License # State (Optional) Please check the session you are going to register for □ NYCTCM Alumni: 50% Discount $100_____ □ NYCTCM Student: 50% Discount $100____ □ Member of ASNY, UANYSLA, ATCMS: $125____ Seminar 12: $200__ □ NYCTCM Alumni: 50% Discount $100_____ □ NYCTCM Student: 50% Discount $100 ____ □ Member of ASNY, UANYSLA, ATCMS: $125____ Sign for both Seminars: $380____ Payment Method: Check or Money Order Send this form with your payment to: NYCTCM New York College of Traditional Chinese Medicine 155 First Street Mineola, NY 11501 Attn: Dr. Xu, CEU Coordinator Or log on www. nyctcm. edu and pay through Pay. Pal Space is limited. Reservations will be according to the order of applications received. Please send your payment 7 days before the seminar. Full refund if you withdraw before the registration deadline (except registration fee)$10 fee for registration at door New York College of Traditional Chinese Medicine Continuing Education Program 155 First Street, Mineola, NY 11501 Tel. (516) 739 -1545 Fax (516) 873 -9622 www. nyctcm. edu Seminar 11: $200__ Continuing Education Program 2013 I Ching Philosophy Applied in Chinese Medicine By Wei Chieh Young, Ph. D. , L. Ac. Part One (Seminar 11) 10 AM – 7 PM, Sat. 10/19/2013 (NCCAOM PDA Points: 8) Part Two (Seminar 12) 10 AM – 7 PM, Sun. 10/20/2013 (NCCAOM PDA Points: 8) With English translation 155 First Street Mineola, NY 11501 Tel. (516) 739 -1545 Fax (516) 873 -9622