Santa Clara University


Please print this page, and send it with correct payment to the address at the bottom of this page:

Last Name:

First Name:






Before or by April 15, 2015:
SCU Students: Free
All Other Students: $50
Academic Faculty: $150.00
MD: $200
SLP: $150 (Stipend available. Contact
Performers & Teachers: $50
NATS & VASTA Members: $50
PVSF Members per category: See website
Prior attendees of PVC: Special discount valid until September 15, 2015. $75 for all professional categories (MD, Ph.D., SLP, RN etc. categories,) $50 if prior attendee is a performer
Note: Fee for PVSF sponsored attendee (no registration fee) who wants CEU is $30 & $50 for CME

After September 15, 2015:
Add 20%
On site: Add 30%

50% if cancelled on or after October 1, 2015
Full refund if cancelled before September 15, 2015

This program is accredited for CEU by ASHA, and for CME by ...

US Registration:

Send registration payments by check only to:
, Registration Mgr.
58 West Portal Avenue # 229
San Francisco, CA 94127-1304

Non-US Registration:

Send registration payment to PVSF
Wells Fargo Account

Address any questions regarding payment to Dr. Krzysztof Izdebski (

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