SMI Intermediate Spring Design
Seminar Registration Form

Please use one form per attendee

Please register the following person in the Intermediate Spring Design Seminar:
Date
_______
*First: *Last:
Company:
*Address:
*City: State: Zip:
Country: *E-mail:
*Phone: Fax:
Special Needs:
Register me in the Intermediate Spring Design Seminar as an SMI member for $650.
Register me in the Intermediate Spring Design Seminar as a nonmember for $800.
I would like to pay by:
Check
 Visa
 MasterCard
 American Express
Sorry, SMI cannot bill you. Please send payment at least two weeks before beginning of the workshop. Please note: You are not fully registered until we have received your check in the mail.
Name on Card:
+Card Number: +Exp Date:
_______
* Required Fields
+ Numerals only. No hyphens, spaces or dashes.