Norton School of Lymphatic Therapy
"Evaluation and Management of Head and Neck Lymphedema for SLPs & CLTs"
Registration Form
750 State Route 34 • Suite 7 • Matawan, NJ 07747
(866) 445-9674 Toll-Free • (866) 854-7800 Fax
DESIRED COURSE DATE AND LOCATION
Course Date: Course Location:
CONTACT INFORMATION
Name:   Business Name:  
Home Address:   Business Department:  
Home City, State & ZIP:   Business Address:  
Home Phone:   Business City, State & ZIP:  
Mobile Phone:   Business Phone:  
FAX:   E-Mail:  
PROFESSIONAL PREREQUISITE
Registration is limited to Speech-Language Pathologists, Certified Lymphedema Therapists, and MDs only. CLTs must possess certificates of completion from recognized, comprehensive MLD/CDT training programs.
REGISTRATION AND PAYMENT

The tuition for the Advanced Topics Course "Evaluation and Management of Head and Neck Lymphedema" is $595. CLTs choosing to begin the Friday class at 1:00pm are eligible for a discounted tuition of $475.

To register, please mail or fax this registration form along with tuition paid by check or credit card and a copy of your professional license/diploma.
 
Payment Type:
Check:     Made payable to "Norton School of Lymphatic Therapy"
Credit Card:     Mastercard     VISA     American Express     Discover
Card Holder's Name:                                
Account Number:                                
Exp. Date (MM/YY):                                
NOTE: If you are paying by credit card you may either include the information in the area above or call us to provide the information by phone.
TRAVEL AND ACCOMMODATIONS
Would you like to receive hotel information?     yes     no
Would you like to receive directions?     yes     no

Back to the Home Page

©2003-2011 Norton School of Lymphatic Therapy - A Division of The Norton Salas Group, Inc.