Register

The New England Society
of Clinical Hypnosis

2008 Workshop Registration Form

Name/Degree:
Professional Specialty:
Institutional Affiliation:
Address:
City, State, ZIP:
Telephone (Office):
Telephone (Cell):
Telephone (Home):
E-mail Address:
Workshop Category (check one)	o	Basic..........................................................................................................	$595.
	o	EEETrainees ( Please enclose identifying letter.)...................................	$350.
	o	Other [ by arrangement ] ...............................................................................
Amount Enclosed ( U.S. dollars ):

Basic Section [4 days]: September 20-21 and October 11 -12, 2008

Newton-Wellesley Hospital
2014 Washington Street
Newton, MA 02462

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Please print out the form above and, with your check made out to NESCH, mail to:

              Gin McErlane, Registrar
              NESCH
              39 Harrison Street
              Newton, MA   02461

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