Online Registration Form for the ADDA-SR Workshop

Have a Winning Year Seminar Series


Fill out the information below completely. Then click on the register button and you will be registered for the conference.


Registration information

 

 

                      Last Name:  First Name:  
                 Street Address:
                               City:
                           County: 
                             State:
                        Zip Code:
                      Telephone:
                           E-mail:
      Credentials/Profession:

How did you hear about the conference?

I would like to become a member. Please include $40 for my membership dues.   Please send my newsletter via e-mail.   
 
Registration cost    
I plan to attend:
 
Team Positions
      August 6
  The Coach’s Playbook
      August 13
  Winning the Game of Success
      August 20
    Price
Registration for 1 event   $20.00
Registration for 2 events   $35.00
Registration for 3 events    $45.00
Membership
Renewal 
New Member  
I am already a member but do not need to renew my membership at this time.
  $40.00
Thank you for  all your work.  I would like to make a donation of    

Total Amount

   

Payment Method:


Master Card**

Discover**

Visa **

American Express **

PO #        

**Print Name on Card:  
** Account Number:  
** Billing Address:  
** Expiration Date:  
I need a certificate of attendance.

Form Submission


 

 

 
This page designed by Opal Harris.
Copyright © 1995 [ADDA-SR]. All rights reserved.
Revised: July 21, 2008.