Integrated Health Care Systems, Inc.

* Enrollment Is Limited – REGISTER NOW *

* Early Registration Suggested to Receive Discounts and Reserve Your Space in the Courses
* Payment Plans Available *

Additional Registration Contact Information: For Seminars, Courses or Retreats: Phone 727-867-2666 Ext 1#; Fax: 727-867-8580; Email: SSBegley@aol.com; Mail: c/o Integrated Health Care Systems, PO Box 67153, St Petersburg, FL 33736

*Please Note Differences in Registration Information for Various Seminars/Courses & Retreats*

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General Seminar/Course Registration Information:

Select the Appropriate Course Registration Form:

Basic Therapeutic Touch Course =1

IHCS Retreats = 2

GENERAL INFORMATION

Early Registration: An Early Registration Fee is offered if payment is postmarked one month prior to the course. For details, please see each specific course or retreat (1,2, or 3) and Registration Forms below.

Payment Plan: Send a minimum deposit of $100 to reserve a space in the class. Contact IHCS to arrange a Payment Plan that works for you. A signed letter outlining the dates your payments will be made must accompany your deposit. If only one additional payment will be made, please give date and sign this form. Balance will be paid on ___________, as prearranged with IHCS.

Please Note: If you are unable to make payments on time, it is your responsibility to contact IHCS for revision of your Payment Plan in advance of payment due date.

Cancellation Policy: Cancellations must be received in writing and postmarked 2 weeks before course start date to receive registration refund minus a 15% processing fee. After this date, registration may be transferred to another course within the same calendar year with an additional 15% transfer fee added to the original registration fee.

Program Changes: IHCS reserves the right to make program changes as necessary, and the right to cancel a program if minimum enrollment has not been reached or events occur beyond reasonable control.

1.  BASIC THERAPEUTIC TOUCH SEMINAR

FORM HAS 2 PARTS: A & B

Please complete all information

Part A

Please select all that is applicable:

_____ $295 Early Registration Fee (To be postmarked one month prior to the course)

_____ $325 Full Registration Fee
           Group Discounts for 3 or more registering together  = $10 off registration fee.

_____ $100 Payment Plan Deposit (Please include signed letter including future payment dates.)

If Additional CE credits are desired, add an additional $35 for each discipline, i.e. RN, LMT, LCSW

_____ Additional CE Fees (Add $35 for each additional CE credits per discipline,

i.e. RN and LMT and LCSW, etc.) Discipline(s)___________________________

2.     Retreat Registration

FORM HAS 2 PARTS A & B

Please complete all information

Part A

Retreat Fees, Cancellation Policies and Payment Plans are different than Seminar/Course Registration Fees. Please Call for More Complete Information Related to the Retreats.

We will be happy to provide additional information to you and explain all details that relate to the various Retreats.

Please Note: Due to the need to make long range plans for retreats to secure lodging, reserve ground and air transportation, schedule adjunct faculty and events, and the need for minimum numbers of participants to make the retreats possible, retreat deposits are nonrefundable.

Cancellation Policy: IHCS reserves the right to cancel retreats if minimum enrollments are not met. If retreat is cancelled by IHCS, all registration fees will be refunded. If a cancellation is made by the participant, deposit and payments will be applied to the next IHCS retreat. Any increases in future retreat fees will be applicable.

For more information, please call IHCS at 727-867-2666 Ext 1#. 

GO TO PART B _________________________________________________________

PART B

Please make checks payable to Integrated Healthcare Systems, Inc. and mail to:

Integrated Health Care Systems, PO Box 67153, St. Petersburg, FL. 33736. (Continued)

Name_________________________________________________________________

Signature______________________________________________________________

Name of Course or Retreat________________________________________________

License Numbers_______________________________________________________

Address, City, Zip_______________________________________________________

Phone Day and Evening__________________________________________________

Email Address_________________________________________________________

Before mailing Registration Form, please complete all information, sign and send all pages.

An incomplete Registration Form does not guarantee your reserved space in seminars, courses or retreats and will be returned for completion.

Please Note: IHCS Seminars, Courses and Retreats are designed for Small Groups, therefore Space is Limited!

For more information, please call IHCS at 727-867-2666 Ext 1#  - or-

Email us at SSBegley@aol.com

Thank you!!