Online Registration Form

Register three ways:  online, mail or fax




Please fill in completely




Name:


Mr. Mrs.  Ms.

Badge Name:

Credentials (EA, ABA, CRTP, Etc)

Address:

City:

State:

Zip Code:

Country:

Phone:

Fax:

E-Mail:

Member of:
  CSATP NSA   Wine Country Chapter








Full Registration Includes 14 hours CPE, Reception Saturday Lunch & Winery Dinner




Thursday or Friday
Includes 8 hours CPE and Reception



Saturday
Includes 6 hours CPE and Lunch


Spouse/Guest
Includes Reception and Winery Dinner
We will/will not attend

 Name of Guest:
Wine Tour & Lunch @ $ 85.00 per person

Additional reception Thursday @ $25.00 each

Additional luncheon
Saturday @ $30.00 each


CSATP DUES

Join now! We will waive the $25.00 processing fee.Plus give you $25.00 towards 2009 Symposium.



TOTALS:


Credit Card Type:

Credit Card Number:

Exp Date:

Billing Zip:


Credit Cards Accepted: