Employment Law Seminar Registration

SEMINAR REGISTRATION FORM

To Register:  Click Seminar Registration Form or:

  1. Call (972) 492-0895, or
  2. Print out this form and Fax to (972) 306-1692 or
  3. Mail form to: Whiting & Associates, P. O. Box 117616, Carrollton, TX 750011-7616, or
  4. E-Mail required information to: registrar@whitingassociates.com

_____  Yes! I want to register for the Employment Law Seminar
_____   I am unable to attend, but would like to purchase the seminar materials for $169.00.
_____   I am unable to attend at this time, please add me to your mailing list for future programs
_____   Please send me information about in-house training programs

Your Priority Registration Code:  __ __ __ __ __   (Found on mailing label above company name & address)

1)  Please Indicate Seminar Date and City Desired:

City: _________________________________     Date: __________/___________/______________

2)  List Names of Participant(s)

1)   Mr./Ms.___________________________________________________ Title: _____________________

E-Mail Address: _________________________________________________________________________

2)   Mr./Ms.___________________________________________________ Title: _____________________

E-Mail Address: __________________________________________________________________________

3)   Mr./Ms.___________________________________________________ Title: _____________________

E-Mail Address: __________________________________________________________________________

 3)  Company Information:

Company Name: _________________________________________________________________________

Phone: (_______) _______________ FAX: (_______) _______________ # Employees in Company: ______

Address: _______________________________________________________________________________

City: ____________________________________________ State: _______   ZIP Code: _______________

4)  Please check method of payment:

  ____ Will mail check to Whiting & Associates, Inc, P. O. Box 117616, Carrollton, Texas 75011-7616

____Bill company   (Refer to P.O. # ________________)

Charge To:  ___AMEX ___VISA   ___MasterCard   ___Diners Club

Card #_________- _________ -_________- _________ Expiration Date: ____/____ V Code: _______

Card Holder’s Name As It Appears On Card:_______________________________________________

Cardholder’s Signature: _______________________________________________________________

Credit Card Billing Address: _____________________________________________ Zip Code_______

 THANK YOU FOR YOUR REGISTRATION TO THE EMPLOYMENT LAW SEMINAR!