Mail In Registration -

Mail In Registration Form

Please print off this form & mail with check or money order.

Mail to Terry Clark, P O Box 180126, Dallas, TX 75218

Make check payable to NAIFA Fort Worth Chapter

To meet price deadline, also e-mail a copy of your registration to

terry@asapapprasal.com or fax a copy to 972 864 8798.

FOR COURSES/PRICING, GO TO THE ON-LINE REGISTRATION PAGE

Name:___________________________________________________

Mailing Address___________________________________________

City/State/Zip___________________________________________

Office Phone/Cell Phone____________________________________

E-Mail___________________________________________________

Member: Yes No

Voucher: Yes No

Course/Seminar:____________________________Price__________

Course/Seminar_____________________________Price__________

Total $$ Amount __________________

(Check Enclosed/Check #____________)

(Money Order Enclosed/MO#______________)

RECOMMENDED: FULL REFUND seven days prior to course date. Cancellations three to six days prior to course date require a $50 cancellation charge for USPAP (to cover books) and a $20 cancellation charge for other courses/seminars. Only special circumstances permit a refund past the three day deadline. PLEASE BE AT THE CENTER THIRTY (30) MINUTES BEFORE CLASS TIME, i.e., 7:30 am for an 8:00 am class.