codeaccess SEMINAR REGISTRATION FORM     
Office Use Only:  C_____    CL_____  D_____    O_____
Please complete the following form, print the form, and mail it with your check to:
codeaccess; PO Box 131358; Birmingham, Alabama 35213. Or Fax it to: (205) 595-1578.
Phone us at (205) 533-4260 or email us at michelereisner@mac.com for more information.
ONE REGISTRATION FORM PER PERSON PLEASE.
SELECT SEMINARS BELOW:
Clearwater Beach, FL Plantation, FL   Atlanta, GA  
May 10, 2010 $325* May 12, 2010 $325* June 25, 2010 $325*
     
Birmingham, AL Nashville, TN  
September 24, 2010 $325* November 12, 2010 $325*  
Ms.   Mr.   Dr.      

Name: Preferred to be called:
Title: Firm:
Address:      
City:

State:

Postal Code:

 
Country:  

Telephone:

  
How would you like to receive your confirmation?
                           Fax:             Email:
Would you like us to notify you of upcoming seminars by email in the future?
                                  Yes             No
                            WE WILL ONLY YOU EMAIL YOU IF AUTHORIZED TO DO SO.
ACCESSIBILITY: To help ensure accessibility, please indicate any accommodations you may require.
* Seminar Fee Policy: The fee for each seminar is as posted above. If three or more participants from the same firm attend the same seminar location, the seminar fee for each of the three or more participants will be $292.50 (a 10% discount). codeaccess reserves the right to cancel any seminars due to inadequate registration numbers, inclement weather, or emergency, in which case, seminar fees will be fully refunded.

 

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04/28/2010