Options 4 Health is Now
offering
Continuing Education
Classes
as a NCBTMB Provider
(Provider Number
450701-08)!!
_________________________________________________________________
Registration Form
(for all Classes)
Mail to : 5435 Bull
Valley Rd. Ste #118,
Valley View Commons,
McHenry, IL 60050
or Email to:
SandyCarmichael@charterinternet.com
Name:
___________________________________________
Address:
_________________________________________
City:
____________________________
State: ____________
Zip:_________
Telephone:_______________________
Email:____________________________
Total amount enclosed:
$___________
(Make checks payable to
Options 4 Health)
VISA___ MASTERCARD___
CARD# ____________ EXP
________ 3 DIGIT ID ____
**All Classes require
1/2 deposit, To receive
full refund, you must
cancel within 3 days of
the class dates.
If less than 3 days, a
$15 fee will be
deducted.
__________________________________________________________________
