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“Exploring the Symptoms of Chronic Illness”

April 30, 2006

Pre-registration Deadline April 1, 2006

Name:__________________________________________________

Phone:_________________________________________________

Mailing Address:_______________________________________

_______________________________________________________

Additional Registrants:________________________________

Email Address:_________________________________________

Please mark the lectures below that you are interested in attending.
This is not in any way binding-you may still attend another lecture on April 1st
but will help the Assoc. plan appropriate seating accommodations for lectures.

10:15 am	Keynote: Beyond Exhaustion...ALL

12:30 pm	CFS, FM & Hypothyroidism OR
12:30 pm	Cognitive Function in CFS		

1:30 pm		SS and LTD…  OR		
1:30 pm		Patient Advocacy Initiative

2:30 pm		Estrogen and Headaches…  OR
2:30 pm		A neurologist's perspective

3:30 pm		Interstitial Cystitis  OR		
3:30 pm		Orthostatic Tolerance

Enclosed is a check for:

$10 members		x _____# of people =$______

$15 non-members		x______# of people =$______

Sub Total.				    $______

$25 yearly membership			   +$______

New or renewal membership (circle one)

Total					    $______


Please make checks payable to CT CFIDS & FM Assoc., Inc.
and mail to:
CT CFIDS & FM Assoc. Inc.-Conference
P.O. Box 3010
Milford, CT  06460