Seminar 2024-4 Registration Form
Seminar 2024-4: Chinese Scalp Acupuncture
Speaker: Dr. Jishun (Jason) Hao 
Date & Time: August 24 & 25 [10AM-6PM](12 NCCAOM & CAB Points)
Location: Room 410-5, NYCTCM Mineola Campus
Address200 Old Country Rd, Suite 410, Mineola, NY 11501

Please complete all applicable items. 
Sign in to Google to save your progress. Learn more
Email *
Attendee's Last Name *
Attendee's First Name *
Attendee's Email Address *
Type of Registration:
*2024-4 Early Bird (By August, 17) - $340
*2024-4 Alumni Early Bird (By August, 17)- $240
*
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of New York College of Traditional Chinese Medicine.

Does this form look suspicious? Report