THIS IS NOT AN ONLINE REGISTRATION FORM - FOR PRINT ONLY
Printed Date: 9/26/2024 5:21:28 PM
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Seminar Title: |
Borderline, Narcissistic, Antisocial and Histrionic Personality Disorders: Effective Treatments for Challenging Clients |
Seminar Date: |
Wednesday, January 29, 2020 |
Seminar Location: |
NORCROSS, GA 30092 |
Seminar ID: |
76569 |
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________ HI, NM attendees add applicable sales and local taxes**
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________ Subtotal (Required items + sales tax)
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Magazine Subscription |
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________ AL, AR, AZ, CA, CO, CT, DC, FL, GA, HI, IA, ID, IL, IN, KS, KY, LA, MA, MD, ME, MI, MN, MO, MS, NC, ND, NE, NJ, NM, NV, NY, OH, OK, PA, RI, SC, SD, TN, TX, UT, VA, VT, WA, WI, WV, WY attendees add applicable sales and local taxes**
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________ Subtotal (Magazines + Optional items + sales tax)
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** Tax-exempt customers please send a copy of your tax-exempt certificate.
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*** Registration for coordinator or military member discount must be completed online
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**** All prices are shown in US Dollars ****
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Prepayment is REQUIRED |
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Check enclosed
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Signed Purchase Order enclosed
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Mail or Fax to:
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PESI, P.O. Box 1000, Eau Claire, WI 54702-1000 (800) 554-9775 (fax number) |