Payment:

_____Enclosed Check (Must be received prior to course date.  $30.00 fee for returned checks)

_____Visa _____Mastercard

Name of Attendee_____________________________________________________________

Address_________________________________________City______________________State_______Zip__________
Email______________________________________­­­_________Phone___________________

Name on Card _________________________________
Card #________________________________________

Company (only required for business credit cards)_____________________________________________

Expiration Date__________________________       

Billing Address (if different than above)_____________________________________________________

Cardholder Signature_________________________________________Date________________________

Refund Policy:  Notice of cancellation must be received at least 7 business days prior to the date of the seminar.  A $25.00 administrative fee will be charged for all cancellations.  No refund will be given if cancellation falls within the period of 7 business days before the seminar.  Individuals may transfer to another course for a $25.00 fee.  Notifications received the day of the seminar or after will result in loss of full registration fee.