Understanding and Managing Visual Deficits
A Guide for Occupational Therapists

Welcome to our online registration page. By using our online registration, you can pay on-line with a credit card through a secure server or, if you prefer, you may also print a completed order form and fax or mail it to us.
Registration Type:  Online Registration   Fax/Mail Registration
How did you learn about this course?
Select Date/Location:	(Select)
Select Tuituion:	# People Rate Description $360.00 (2 Days) 30 Days before course date $180.00 (1 Day) 30 Days before course date $390.00 (2 Days) Within One month of the course date $195.00 (1 Day) Within One month of the course date $330.00 (2 Days) Group Discount (3+), Within One month of the course date $300.00 (2 Days) 60 days before course date $110.00 (2 Days) Student Rate (ID Required at Door)
First Name:
Last Name:
Degree:
Email:
Billing Address:
City:
State/Prov:
Postal Code:
Country:
Primary Phone:
Alternate Phone:
Fax:
Pre-Order Book(s):	# Books Price Title $73.00 Low Vision Rehabilitation: A Practical Guide for Occupational Therapists $70.00 Understanding and Managing Visual Deficits: A Guide for Occupational Therapists
* Items in RED are Required Fields