WildAgain Wildlife Rehabilitation, Inc.

Registration Form - Tennessee Homeopathy with Wildlife Seminar 

February 12-13 & 14, 2005

Please print out and complete this form and mail or fax 45-60 days prior to the scheduled seminar date. Make your check or money order payable to "UT Chattanooga" and send to UTC Continuing Education, Siskin 118, Dept. 5255, 615 McCallie Avenue, Chattanooga, TN 37403 or fax to (423) 425-4170. Please register early, as seminar size is limited.

The registration cost for rehabilitators or rehabilitation volunteers for the two-day seminar, including the Handbook, is $95. The cost for two rehabilitators registering from the same household and sharing a seminar manual is $125. The cost of the optional third day (Monday) is $45.

Name(s)______________________________________SS#________________

Address__________________________________________________________

City, State, Zip___________________________________________________

Phone_____________________Email__________________________________


£ Check enclosed

£ Credit (Visa or Mastercard)

   Credit Card number ____________________ Expiration date ____________

   Name on Card __________________________________________________

Circle your registration category below:

  $95    Rehabber (or affiliated with a rehabber)

$125   Two people, same household, sharing a seminar manual

  $95    Vet tech, or student (vet/vet tech)

$150    Veterinarian or non-rehabber

  $45     Attendance at the optional advanced third day on neurological conditions

$_____  Total Registration fee enclosed (check or money order only)

The seminar runs from 8:30 to 5:30 each day with sign-in at 8am. An attendance certificate will be provided for continuing education credit. A confirmation letter with maps and hotel information will be sent when paid registrations are received. Ground transportation options will also be provided from the closest airport.

If you have other questions about the seminar or registration, please email WildAgain or call WildAgain at 303-670-3309 or UTC Continuing Education at 423-425-4344.

 

Copyright 2004. © WildAgain Wildlife Rehabilitation, Inc. All Rights Reserved unless otherwise stated.