Future Medicine Today, Inc

Secure Seminar Payment Form

Select Seminar

NOTE: For teleseminars location select other.

Your Contact Info - Please list name as you wish it on certificate

Payment Information

I wish to pay *
Course prices can vary by region - please see the shopping cart for prices of specific courses.
 
We prefer that you pay in the shopping cart or over the phone. We provide this form if you are having trouble paying online, and we understand that sometimes it is inconvenient to call during our office hours.
 
Please note that all payments are processed in US Dollars.  Full payment is due 4 weeks prior to the seminar commencing to confirm your place.

The Name and Address fields below are optional. You only need to enter them if the name on the credit card or the billing address for the credit card is different than above.

All information is collected using secure server encryption. Your credit card will not be charged until all information has been reviewed. PLEASE use spaces in credit card number for clarity/accuracy. 

CVV2 code is the 3 digit code found in the signature area of VISA, MC, Discover cards.
CVV2 is the 4-digit non-embossed code on the front of American Express cards.