ICAC Trademark of quality in continuing education programs
APPLICATION FOR MEMBERSHIP

Educational Background:

DUES
NOTE: Membership in ICAC does not make you a member of ICA. Membership in ICA does not make you a member of ICAC. ICA and ICAC are independent of each other.

PAYMENT : please call for payment

Note: Student or Graduate dues is a one time fee paid in full on submission of application.

To apply for discount, complete the Authorization for Payment form.

*Please submit all licentiate names and applicable clinic addresses on letterhead stationary. Send to address below.


International Chiropractors Association of California
Membership Committee
9700 Business Park Drive, Suite #305
Sacramento, CA 95827-1718
Phone: (916) 362-8816 (800) 275-3515 FAX (916) 362-4145


Membership Dues Discount

Discounts are given for either, 1) prepayment of a full year of dues, or 2) payments pre-authorized and automatically paid by either credit card or automatic debits to checking account. If you wish to apply and receive $120 annual reduction in dues, please complete the following Direct Payment Authorization.

DIRECT PAYMENT AUTHORIZATION
and Agreement for $120 per Year Reduction in Dues

I hereby authorize the International Chiropractors Association of California (ICAC) to initiate debits and credits to my checking account per attached voided check below, or to charge to my credit card account as authorized on my ICAC Application for Membership. By forwarding this agreement, I understand I am receiving a $120 per year reduction in dues.

FULL ONE YEAR DUES PAYMENT

AUTOMATIC MONTHLY DEBIT OR CREDIT CARD
($120/YR OFF MONTHLY FEES)

In order to insure the safety of our Registration system, we are not currently taking credit card payments on-line. Yes, your on-line registration will be processed. However, to pay with your credit card, call ICAC (800)275-3515. We will take your credit card over the telephone. You can also finish your registration on-line and then pay the PREREGISTRATION RATE (NO ADDITIONAL FEES), even it you bring a check or credit card to the door. You don't have to be a member to attend this seminar.

Return to Top of ICAC Application


captcha