Registration Form - The Chicago School of Professional Psychology
Registration Form - The Chicago School of Professional Psychology
Registration Form - The Chicago School of Professional Psychology
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*Students:<br />
Member<br />
Non-Member<br />
Non Members<br />
Pr<strong>of</strong>essional<br />
75.00 75.00<br />
75.00<br />
50.00<br />
100.00 100.00<br />
125.00<br />
50.00<br />
400.00 400.00 450.00 See Country<br />
Dues<br />
Person-Accompanying 100.00 100.00 100.00<br />
• Country <strong>of</strong> residence determines registration fees above:<br />
Category A Countries:<br />
Australia, Austria, Bahrain, Belgium, Brunei, Canada, Denmark, Finland, France, Germany,<br />
Great Britain, Greece, Hong Kong, Iceland, Ireland, Israel, Italy, Japan, Kuwait, Luxembourg,<br />
Netherlands, New Zealand, Norway, Portugal, Qatar, Saudi Arabia, Singapore, Spain, Sweden,<br />
Switzerland, Taiwan, United Arab Emirates, USA.<br />
Category B Countries:<br />
Antigua & Bermuda, Argentina, Bahamas, Barbados, Brazil, China, Croatia, Cyprus, Czech<br />
Republic, Iran, Korea, Malaysia, Malta, Mexico, Oman, Poland, Seychelles, Slovakia, Slovenia,<br />
South Africa, Suriname, Turkey, Venezuela, Yemen.<br />
Category C Countries: All other countries.<br />
• Student status statement from the university department is required<br />
<strong>Registration</strong> includes:<br />
• Full access to All Congress Scientific Sessions<br />
• Congress Badge<br />
• Book <strong>of</strong> program/Abstracts<br />
• Opening Ceremony & Welcome Reception [cash bar]<br />
<strong>Registration</strong> for accompanying persons includes:<br />
• Admittance to the Opening Ceremony & Welcome Reception<br />
• Special ICP Prices for Organized tours & dinners<br />
• Full access to All Congress Scientific Sessions<br />
SUMMARY OF PAYMENTS SUBMITTED FOR SCIENTIFIC PROGRAM, WORKSHOPS,<br />
AND SOCIAL EVENTS:<br />
US Dollars<br />
SCIENTIFIC PROGRAM<br />
REGISTRATION ICP Membership Status: [CIRCLE ONE] A B C Student<br />
Pr<strong>of</strong>essional Accompany<br />
Accompanying Person(s)<br />
REGISTRATION<br />
Name[s]:<br />
SOCIAL EVENTS: AUGUST 4 AUGUST 5 AUGUST 6 AUGUST 7<br />
LUNCH 25.00 25.00 25.00 25.00<br />
BANQUET 50.00<br />
CONTINUING EDUCATION [pay onsite]<br />
1. APA CE $15 per Hour<br />
2. ICP World Continuing<br />
Education $10 per Hour<br />
Total Payment Submitted: $<br />
CHECK ONE<br />
PAYPAL<br />
CHECK
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