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Name:
(As you would like it to appear on your name
tag)
_______________________________________________________
Date:_______________________
Address:____________________________________________________________________________________
City:
___________________________________________
State:_________________ ZIP:
______________
Phone
(Day): ( _____ )______________________
Phone (Evening): ( _____ )
_________________________
E-Mail
Address: _____________________________________
@ _____________________________________
(Check
One) [_] Paying by Check
(Make payable to CLASS)
[_] Please Charge my Credit
Card
Card
Type: ________________________
Card #
________________________________________________
Exp.
Date: _________________ 3-Digit Security
Code (back of card): _________________ (4
#'s on AMEX)
Name
on Card:
_____________________________________________________________________________
Signature:
__________________________________________________________________________________
If
you prefer, credit card registrations may be placed
by phone at (800) 433-6633
or by FAX at (505) 899-9282.
I
will attend (Check
One):
[_]
May 5-7 (Austin, TX)
[_]
August 18-20 (Livermore, CA)
[_] September 8-10 (Jamestown,
NY)
[_]September
29 - October 1 (Atlanta, GA
Area)
[_]November
17-19 (Indianapolis, IN Area)
Amount
Enclosed (Please
check the appropriate box below)
CLASSeminar
Registration
Professional
Track:
[_]
$450 Regular Registration
Personal
Enrichment:
[_] $375 Regular Registration
Alumni Registration:
[_] $350**
Seminars
are subject to cancellation 30 days
before.
Cancellation
Policy: Cancellations must be received in
writing 30 days in advance. Written cancellations
received before the 30 day deadline will be
promptly refunded, less a nontransferable $100.
Cancelations received after the 30 days will be
eligible for transfer to another CLASSeminar but
will be subject to a $50 transfer fee.
Cancellations received within 72 hours of the event
are nonrefundable nontransferable.
Please
print this registration form, then mail completed
form and check or money order to:
CLASServices
2201 San Pedro NE
Building 1 Suite 225
Albuquerque, NM 87110
or
FAX credit-card registrations to (505)
899-9282
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