COURSE REGISTRATION:
 
____ Evaluation and Treatment of Cervicothoracic Spine I,  July 17 - 18, 2010
 
____ Evaluation and Treatment of Lumbo-Pelvic-Hip Complex Dysfunctions, August 7 - 8, 2010
 
____ Sleep and Sleep Disorders for the Rehab Professional,  August 20, 2010
 
____ Evaluation and Treatment of Cervical Thoracic Spine Dysfunction II + Balance,   November 6 - 7, 2010
 
____ Evaluation and Treatment of Lumbo-Pelvic-Hip Complex Dysfunction II,  February 5 - 6, 2010
 
Tuition:
2 day courses - $395 (four or more weeks prior to course) $450 (less than four weeks prior to course)
1 day courses - $175 (four or more weeks prior to course) $190 (less than four weeks prior to course)
Discounts available for multiple class registration.
 
 
Please mail your completed form along with your check payable to:
CORE Services 7508 Big Bend Blvd. St. Louis, MO 63119
or send your information by FAX or email: FAX: (314) 647-1964 email: info@coreservices.org
 
NAME: _______________________________________________________________________________
 
ADDRESS: ____________________________________________________________________________
 
CITY: ________________________________________________________________________________
 
STATE: _______________________________________________________ ZIP: ____________________
 
PHONE: ________________________________     EMAIL: _______________________________________
 
EMPLOYER: ____________________________________________________________________________
 
PROFESSION/LICENSE #: _________________________________________________________________
 
TOTAL TUITION PAID: ____________________________________
 
CREDIT CARD (Visa, MasterCard, Discover) CARD #:                                     Expiration:
 
____________________________________________________              _________________________
 
Authorized Signature: ___________________________________________________________________