Event RSVP Form

Date: Thursday, November 11, 2010 8:15-3:45 pm EST

Professional Workshop: Deciphering the Hunger Code: Treating Eating Disorders with Imagery & Metaphor

Presented by: Anita Johnston, PhD

Location:
Hilton Garden Inn, Atlanta Perimeter Center
1501 Lake Hearn Drive
Atlanta, GA 30319

Cost:
$99 Professionals
$69 Students with ID
Lunch is included

For additional information, contact Melissa Rogers at 800-675-2041. See also our Event Brochure.

RSVP requested to Melissa Rogers by November 1, 2010. To RSVP:

Call Melissa at 423-308-6577, OR
Download and print this form Anita Johnston Workshop RSVP Form, and Fax it to 423-308-2561, OR mail it to: Melissa Rogers, Focus Healthcare of TN, 7429 Shallowford Road, Chattanooga, TN 37403
OR complete the online form below.

Workshop payment is accepted at the door.

Please contact Melissa Rogers for information regarding special needs, cancellation and refund policy.

First Name:		Last Name:
Organization (Company or School):
Address 1:
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		ZIP Code:
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Are you registering as a: Professional Student
If as a student, what is your Degree Program:
Pleaes indicate your credentials, type of license of License and/or Degree:

Focus Healthcare of Tennessee