Cooperative Learning Network Registration Form

Basic A&A Seminar
Tuesday, December 12, 2017
11:00 AM ET / 10:00 AM CT / 09:00 AM MT / 08:00 AM PT [Prevailing Time]

Presenter: Phil Miller, NSAC Assistant Director of Education and Don Frederick, Retired

Cost: NSAC Members (Free), Non-Members ($85.00)
NSAC Member
Non-Member
Listing of Additional Participants: Full name and email is required for each
Full Name
Email
One Certificate of Attendance is included for the primary registrant. Additional certificates are available for $10 each and will be invoiced separately. Certificates are provided for the number of CPE credit hours promoted.
Billing Information    Same as above
Payment Information
Valid promotional discounts will be calculated during processing.
(3 or 4 digit code on back of card)