Payment Information
for Professionals


Checks should be drawn in U.S. dollars, payable to CHERAB Foundation. On the memo line, please write "for EFA and Apraxia Conference".
Please mail your checks and completed
registration form to us at our mailing address.
Credit Card payments must be sent by mail or fax.

Print the completed registration form, along with your credit card information (below).

1.
Mail the completed registration form and credit card information
OR
2.
Fax the completed registration form and credit card information
Required Credit Card Information: (Please print this form)

Card Type:
Card Number:
Expiry Date:
Name on Card:
Billing Address1:
Address2:
(Include Zip Code)
Registration Fee:
Dinner Fee:
Comments/Special Instructions
Registration Fee. . . . . . . . . . $150.00
for scientific sessions on both days (includes mid-morning snack & lunch)
Festive Dinner. . . . . . . . . . . . $50.00