REGISTRATION FORM Registration is not valid until deposit is received. 50% of remainder must be received no later than SIX weeks before the seminar or conference begins. Balance due TWO weeks before the seminar or conference begins.
Please contact us for fax or mailing address.
Your organization name:
Printed name and title of conference or seminar organizer:
Please reserve the following date:
First choice:
Second choice:
Third choice:
Conference or seminar requested (circle one):
Calculation of deposit: $________________ x "admission" x 15% = $_____________________
Cancellations within six weeks of seminar or conference are completely non-refundable.
I hereby agree to the above terms and conditions.
Signature of conference or seminar organizer:
Title:
Date:
Please note that we accept credit cards - MasterCard, VISA, and Discover. If you wish to pay with credit card, please complete below:
Name of credit card holder:
Street address:
Zip code:
Type of card: MasterCard - VISA - Discover
Card number:
Expires:
Security code:
I hereby authorize use of my credit card in payment of the above deposit for the seminar or conference requested.
Signature of credit card holder: