|Print this page out, fill it out and fax/mail it accordingly.|
CITY ________________________ STATE _____________ ZIP __________
DAYTIME PHONE NO. ___________________________________________
FAX NUMBER _________________________________________________
EMAIL ADDRESS*: _________________________________________________
ENCLOSE FULL TUITION
*Registration confirmations and directions to the hotel will be emailed to you upon receipt of your registration payment. If you don't have an email address, they will be faxed or mailed.
A 10% discount is available for groups of 3 or more registered at the same time. A 15% discount is available for full time students (must include documentation of full time student status). Only one kind of discount can be applied, discounts can not be combined.
NAME OF CARDHOLDER (Please Print Clearly) ___________________________________________
CREDIT CARD # (Please Print Clearly)_______________________________ EXP. DATE ____/____
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