Workshop Registration Form
Carol Z. Brody
November 8, 9, 10 & 11th, 2010
Webster University North Orlando Campus, Sanlando Center, Altamonte Springs
Fee: $250 for CFWS members, $290 for non-members
□ I am a member of CFWS. I enclose $125. I will pay the remaining $125 by November 1, 2010.
□ I am not a member of CFWS, but I would like to join and pay the member workshop fee. Enclosed is $40 for 2010-2011 dues, and $125 for the workshop registration fee. I will pay the remaining $125 by November 1, 2010.
□ I am not a member of CFWS. Enclosed is the $145 registration fee. I will pay the remaining $145 by November 1, 2010.
□ I have already registered for this workshop. Enclosed is the remainder of my workshop fee, due by November 1, 2010 ($145 for non-members, $125 for members).
□ I have already registered for this workshop. I am not able to attend. I am making this request before October 8, 2010. Please refund my registration fee. I understand that the registration fee is not refundable after October 8, 2010.
Name ________________________________________________________________
Address _______________________________________________________________
_______________________________________________________________________
Email Address _____________________________ Phone: ______________________
Please print and fill out this form and mail with your check to: Nancy Sexton, 1380 Branch Hill Ct., Apopka, FL 32712.