Back to Conference Registration

Alliance of International Aromatherapists
International Clinical Aromatherapy Conference and Wellness Expo
Registration Form
Please print this form (2 pages), complete, and mail or Fax to AIA with your payment
Please circle all amounts that apply in this registration form.
If you are registering more than one person, please include all names.
If you need more space, you may use more than one form with payment information on one form.

Category
Regular
Register by
October 5
Late & Walk-In
Register after
October 5
Full Conference
Member
Non Member
Student
$355
$460
$300
$425
$550
$360

One Day

Member
Non Member
Student

$180
$215
$150

$215
$260
$180

Celebration Banquet
$65
$65

Post-Conference Workshop

Please circle the number below for the workshop you want to attend.

1 - Peter Holmes, LAc, MH
2 - Jennifer Jeffries, ND
3 - Debbie Freund, RN
4 - Rodney Schwan

$80

$80

Conference Registration for __________ attendees

$_______________

Celebration Banquet for __________ attendees

$_______________

Post-Conference for __________ attendees

$_______________

Total:

$_______________

Not a member? Join now and save money on registration and enjoy membership benefits.
Learn more. Join now.

Cancellation Policy:
Refund request must be in writing. A $50 fee will be retained for all refunds.
No refunds will be granted after Sep. 21, 2007. Refunds will be made after Nov. 21, 2007.

Please Print
Name(s) _______________________________________________________________________________________
 
Address ________________________________________________________________________________________
 
City, State (Province), Zip _________________________________________________________________________
 
Day Time Phone _________________________________________________________________________________
 
E-Mail _________________________________________________________________________________________

Method of Payment

____ Check** ____ MC ____ VISA ____ Discover ____ Amex
 
Card Number ____________________________________________ Exp. ___________
 
Name on Card (print) _____________________________________________________
 
Signture _______________________________________________________________
** Check or Money Order payable in US dollars to AIA

Mail to: AIA
18121-C East Hampden Avenue #121
Aurora, CO 80013

Or Fax to:
303-400-8450
Questions? Call 303-531-6377