Workshop Registration Form

QUESTIONS/CANCELLATIONS - If you have any questions or wish to cancel, call 1-800-452-8786 (Augusta area: 623-8428). Notification must be given at least 72 hours before the session begins to obtain a refund. Some cancellations are subject to a $10.00 administrative fee for processing. Please see the specific brochure to find out if this applies to your workshop.

Do NOT use the "Enter" key unless you want to submit the form. Move between fields with "Tab" or the mouse.

** Mandatory for submission **

List of current workshops is below this form for easy reference.

** Workshop **	** Location **	** Date **	** Fee **
A value is required.	A value is required.	A value is required.	A value is required.
** Address to be Billed:
A value is required.		Bill to MUST include: Entity (Municipality, Organization, etc.) Street/PO Box/etc. City, State and Zip
Contact Name: (if not registrant)	** E-Mail **	** Phone **
	A value is required.Invalid format.	A value is required.
Please register the following:
Name:	Title:	Attendee's E-Mail:
ADA Compliance: It is our practice to conduct workshops only in ADA compliant facilities. Please notify us in advance if you have additional physical or dietary needs, so that we can assure your comfort and full participation. The space provided below for comments or added information:
You can also E-mail us at wsreg@memun.org.