Practitioner Sign Up Form
Please fill out the form below. You will then be directed to our secure server (paypal) to make a payment via credit card. If you'd like to get the discounted rate, please include either your: a. proof of membership for the AAOM, AOM or your state organization (in the form of your membership number or a contact place for verification); b. an address where you have a link on your site to either of my sites (www.tcmstrategies.com or www.tcmstudent.com).
The red stars mean that field is required.