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Academy
Fee Schedule: $1,800 per person. $1,650 per person with three or
more participants.
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| WORKSHOP REGISTRATION FORM |
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| Course Name: |
Course Date: |
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| Method of Payment: | Amount: $ | |
| Credit Card: | [__] | American Express | [__] | Visa | [__] | Master Card | ||||||||||||||||||||||||||||
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| Card Number | Expiration Date |
| Name as it appears on the card | Signature |
| Purchase Order Number: |
| Invoice: Please send invoice to the attention of: |
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