WCA Conference Registration
Please complete separate registration forms/payments for each individual registrant.
Title *
Dr., Mr., Mrs., Ms.
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First Name *
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Last Name *
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Degree
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Clinic Name *
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Street Address *
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City *
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State *
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Zip Code *
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Office Number *
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Cell Number
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Email Address *
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Chiropractic College Attended
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Conference Registration **Prices increase by $50 after May 4th, 2018
Please indicate if you will be participating in the activities below—this will help us to obtain an accurate headcount for catering services.
Events/Activities:
Printed copy of seminar notes ($25)
Almost finished! Please use the payment button below to complete and pay for your registration.
**Be sure to select any add-ons in the payment menu such as “Printed Seminar Notes” in addition to the Conference Registration Fee if you have selected those items on the registration form.
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