REGISTRATION FORM on PDF  or BELOW:    Please print out and scan to DennisNAJA@aol.com or call (916) 447-NAJA   

  2012 NAJA 29th Annual Conference           March 19 – 23, 2012

REGISTRATION FORM
 
 
Name______________________________       Title________________________________
 
Approving Manager________________________Title_______________________________
 
Organization

 _________________________________________________________________________
 
Address _____________________________________________________________________
 
City, State, Zip Code ____________________________________________________________
 
Phone ___________________________    Cell Phone _______________________________

Email ____________________________ Alternate email ____________________________
 
Registration Fees:                        

 
                     One Day                   $419.00
 
                     Two Days                  $479.00
 
                     Three Days                $589.00
 
                     Four Days                  $670.00
 
                     Five Days                   $719.00
 
Check the days you plan to attend: !"!M    !"!T    !"!W   !"!Th   !"!F    !"! All FIVE days 




Method of Payment:                                                                                                    

  (click to it-secured)


_____ Check enclosed payable to NAJA
              mail to:   NAJA | P.O. Box 221392 | Sacramento, CA | 95831

_____ Purchase order #______________________, copy attached
                scan & email to:  DennisNAJA@aol.com
               Office phone:  (916) 747-NAJA  or  (916)447-6252 & no fax available
              mail to:   NAJA | P.O. Box 221392 | Sacramento, CA | 95822 



             **********************************************
              Full  payment must be received by NAJA for admittance.
             **********************************************
Signature


______________________________________________   Date:__________________

 NAJA
Cancellations:
Substitute registrants are welcome and may be named at any time. If you cancel six or more business days in advance, you will receive a full refund less a $75.00 service charge. If you cancel within five business days you are not entitled to a cash refund.

For more information regarding NAJA administrative policies or to make suggestions, please contact our office at (916) 447-6252, ask for Dennis or Heddy.


This workshop/conference may be recorded. Your registration constitutes your consent to such recording.

Submit registration via email to DennisNAJA@aol.com or mail to:
NAJA | P.O. Box 221392 | Sacramento, CA | 95822
website:  www.NAJAorg.info

To ensure that all of our mailings get to you safely, we recommend that you add DennisNAJA@aol.com to your contact list in your email client.