To register multiple attendees, please duplicate this form.

Full Name*

Title

Company

STREET ADDRESS* (DO NOT USE P.O. BOX, GIVE STREET ADDRESS)

CITY*

STATE*

ZIP*

E-MAIL ADDRESS*

TELEPHONE* (INCLUDE AREA CODE)

FAX (INCLUDE AREA CODE)

Please list the city and dates of the seminar you wish to attend.

(Ask for list of cities/dates orders.)

CITY*

DATES*

Advanced Registration $349
Late Registration $399
Online Primer Registration $430
Test Kit $115

I Have Read The (REGISTRATION FEES CONTENT)*What is 1+1 (provide the number, not the written number)?

REGISTRATION FEES

ADVANCED REGISTRATION:
$349 per person
Requires registration and payment at least
30 days in advance.
LATE REGISTRATION:
$399 per person
Requires registration and payment less than
30 days in advance.
ONLINE PRIMER VERSION:
$430 per person
One day of class.
TEST KIT OPTION:
It is suggested you purchase a test kit. If you
would like to do so, please add $115.