NAET Workshop Registration Form
(print this form and mail or fax)
Dr. Rahmie Valentine
29 Plantation Park Dr. Suite 701
Bluffton, South Carolina 29910
fax number: 843-706-2598
Please enroll me in the following Veterinary NAET Workshop:
Prerequisite: Basic Veterinary NAET
Course Location & Date: Name: ___________________________________________________ Address: ________________________________________________ City:___________________ State: _______ Zip: ____________ Phone: ______________________ Fax: ______________________ E-mail: _________________________________________________
You may register with VISA or Master Card. Please enclose your card # and expiration date.
Card Type: ____________________ Card #: _______________________ Expiration Date: ________ Billing Address Zip Code or 3 Digit V Code from card: __________ Signature: ____________________ Date: ___________________ REGISTRATION DEAD LINE IS , NO ENROLLMENT APPLICATIONS ACCEPTED AFTER THAT DATE. Cancellation in writing 30 or more days prior to event: payment minus $75administrative fee. Cancellation notice 29 days or less, up to 10 days prior toworkshop, forfeit 50% of fee. 10 days prior to workshop forfeits entire fee.
