BSF Online Conference Registration Form
Name
*
Address
*
(where you receive your credit/debit card statement)
Email Address
*
Phone Number
Tuition
SELECT
$297 - BSF members attending dinner event/CE keynote
$327 - New/renewing members - dinner event/CE keynote
$327 - Non-members attending dinner event/CE keynote
$167 - Students - (degree seeking - ID REQUIRED) - dinner included
$267 - BSF members not attending dinner/CE event
$297 - Non-members not attending dinner/CE event
Credit card:
*
SELECT
Visa
MasterCard
Credit card number:
*
Expiration date:
*
CVV2 (3 digit):
**
Name as it appears on credit card:
*
Amount authorized:
*
$
By pressing submit below I authorize the Biofeedback Society of Florida, Inc. to charge my credit card the amount indicated above.
*
required field
**
CVV2 is a required 3 digit security number on back of card
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