Last Name Dr. Surname Title Phone Number E-mail Address Date of Birth (month/day/year, mm/dd/YYY) 2. Payment Information: Cash only. No checks or credit cards. Checks will be held. If there is an issue, please contact your student or financial aid office. Financial aid and registration fees are non-refundable. Receipt must have full name, SSN and mailing address. A 25 credit can be made by using a credit card and a valid student ID. Student cards are usually processed and shipped within 3-5 business days after your card has been issued, if your card has processed without any problems. 3. Refund Policy is as follows: Refunds are not issued after June 14th of the current regular school year, or if an insurance is purchased in the current school year, on or before July 15th. 4. Forms are only accepted via mail or fax, unless you request an electronic form. 5. Registration Fee must be paid in full prior to August 31st, of the current annual school year. Students who have purchased student ID cards will be able to upgrade the registration fee by selecting the upgrade option on the registration form. 6. You must have your registration fees in a current student account. You can transfer your registration to a new account after registration has been held. 7. The total price to register during the registration period is 250.00 minus current fees and discounts which may be applied to the registration fee if applicable. 8. Please see the registration form below for complete information.
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2012 Homecoming Registration Form March 2-3 Port Orange, Fla. Please mail or fax your completed form, along with payment, to: Palmer College of Chiropractic, Continuing Education and Events Department
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