Registration for iaedptm Members' Teleconference Course

REGISTRANT INFORMATION

First Name
Last Name
Street Address
City, State, Zip
Email (required)
Telephone
Employer
Occupation
Work Address
Work Phone
Fax Number
Website URL
Licenses and Degrees
 

Tell us about yourself. Please check all that apply. 
Master Level Therapist Dietitian
Doctorate Level Clinician Physician
Psychiatrist Graduate Student
Undergraduate Student I work in the eating disorders 
    field but am not a clinician
I treat eating disorders in
    an outpatient setting		 I treat eating disorders in 
    an inpatient setting 
Are you a member of iaedp™? No  Yes
Do you treat eating disorders? No  Yes
Did you attend the last Symposium? No  Yes 
 

Have you ever attended an iaedp™ Symposium? (Check box)
I have never attended an iaedp™ Symposium
I have attended at least one iaedp™ Symposium
I have attended more than 2 iaedp™ Symposiums

I regularly attend iaedp™ Symposiums
 

Fees

  

Members $120.00 

 Non-Members $140.00

 

 

 

Please contact iaedptm for assistance. 
**
providing education and certification
promoting effective treatment
iaedptm
The International Association of Eating Disorders Professionals Foundation 
serving the eating disorders professional community since 1985!
iaedptm is a non-profit 501c3 organization
PO Box 1295 * Pekin, IL 61555-1295
Voice: 800-800-8126 * Fax 800-800-8126 *