registration form for intensive seminar in botanical medicine

To reserve space in the Intensive Seminar in Botanical Medicine:
Send this form and a non-refundable deposit of $75 check payable to Botanical Medicine Academy,
P.O. Box 1528, Vashon, WA 98070. The balance is due August 15, 2007.

NAME________________________________________________________________________

ADDRESS;____________________________________________________________________

CITY/STATE/ZIPCODE___________________________________________________________

PHONE _______________________________________________________________________

EMAIL ADDRESS (PLEASE PRINT):

_____________________________________________________________________________

Seminar Fee:

CME Registrants: $570 Early Registration: $520
NON-CME Registrants: $370 Early Registration: $320
Early Registration Deadline: June 30, 2007
Refund for cancellations will be made until August 15, 2007, minus the $75 non-refundable deposit.

For additional information send email to greenfarmacygarden@yahoo.com or call Holly Shull Vogel 301-466-6744

Accreditation
This activity has been planned and implemented in accordance with the Essential Areas and Policies of the
Accreditation Council for Continuing Medical Education through the joint sponsorship of the University of
Maryland School of Medicine, Center for Integrative Medicine and the Botanical Medicine Academy. The University
of Maryland School of Medicine is accredited by the ACCME to provide continuing medical education for physicians
Credit Designation
The University of Maryland School of Medicine designates this educational activity for a maximum of 28 AMA
Physician’s Recognition Award category 1 credits. Physicians should only claim credit commensurate with the
extent of their participation in the activity