International Chiropractic and Interdisciplinary Congress Registration

10th Annual International Chiropractic and Interdisciplinary Congress

Oct. 18-21, 2007
At the beautiful . . .

Hotel Camino Real
Planco, Mexico City
Mariano Escobedo 700
Col. Anzures
Mexico D.F. 11590
www.caminoreal.com/mexico
Tel: (01 55) 52 63-888
Fax: (01 55) 52 63-8889
mexico@caminoreal.com.mx

$400 Chiropractors

$200 Students

*Indicates required fields.

*First Name:
*Last Name:
*Street Address:
*City:
*State:		*Zip:
*Office Phone:		Office Fax:
*Email:
*Date of Birth: (mm/dd/yyyy)
College Attended:
Graduation Month/Year:
States/Provinces of License:	(if applicable)

Once your online registration is received, the Office of Development will contact you with payment instructions or you may pay online now using Visa or MasterCard.

Pay Online using Credit Card
Pay by phone, mail, or at the door.

Copyright © Northwestern Health Sciences University, 2501 W. 84th St., Bloomington, MN 55431, (952) 888-4777.
Send your questions/comments about the website to Northwestern Health Sciences University Web Coordinator.