Illinois Prairie State Chiropractic Association

FALL CONVENTION REGISTRATION FEES - BASIC MEMBER

Thank you for your registration...We look forward to seeing you there.

Top Golf is included with registration. Meals are NOT included with your registration but can be purchased.

**BASIC REGISTRATION Before 7/20 After 7/20**
Chiropractor	$365.00	$395.00
2nd DC - Same Office	$325.00	$355.00
Retired Chiropractor	$185.00	$185.00
1st Year DC	$0.00	$0.00
Chiropractic Assistant (CA)	$155.00	$155.00
IPSCA Student	$0.00	$0.00

**MEAL TICKETS**
Additional Friday Evening Top Golf	$40.00
Saturday Beacon Breakfast	$30.00
Saturday Luncheon	$35.00

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Description	Fall Convention-Basic Member
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I affirm that the information entered on this form is true and correct and further declare that I have read, understand and accept Illinois Prairie State Chiropractic Association Terms as referenced in the [Terms of Use] link below.

Illinois Prairie State Chiropractic Association
PO Box 4174 Rock Island, IL 61204
(309) 797-9799

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