No. of Registrants: x (fee) = $ REGISTRATON FEES Check enclosed -- make payable to: National Indian and Native American RECEIVED ON OR BEFORE Employment and Training December 31, 2013 $375.00 VISA/MasterCard per person Card Exp. RECEIVED AFTER Cardholder’s Signature: December 31, 2013 $450.00 per person Cardholder’s Name (printed): ONSITE RATE $500.00 Card Billing Address: per person INCLUDING ZIP CODE Discount Rate for Presenters Card Billing Phone No. If special accommodations for disabled individuals are needed, please notify Mail form and payment to: , NINAETC Treasurer NINAETC by March 31, 2014. 2014 NINAETC Executive Committee Early registration helps with planning activities AND saves you money. For further information, call: (916) 920-0285; (800) 748-5259 TTY; (916) 641-6338 fax – – All registration fees are FOR NINAETC USE ONLY non-refundable. PAID BY: CK. AMT.: $___________ CK. NO.: #_______________ CASH $ PO AMT.: $___________ OTHER CREDIT CARD AMT.: $___________ AUTHORIZATION CODE: TOTAL AMOUNT REC’D: $______________ REC’D BY_______________ DATE:
REGISTRATON FEES RECEIVED ON OR BEFORE December 31, 2013 $375.00 per person RECEIVED AFTER December 31, 2013 $450.00 per person ONSITE RATE $500.00 per person Discount Rate for Presenters If special accommodations for disabled individuals are needed, please notify NINAETC by March 31, 2014. Early registration helps with planning activities AND saves you money. All registration fees are non-refundable. No. of Registrants: x (fee) = $ Check enclosed -- make payable to: National Indian and Native American Employment and Training VISA/MasterCard Card Exp. Cardholder’s Signature: Cardholder’s Name (printed): Card Billing Address: INCLUDING ZIP CODE Card Billing Phone No. Mail form and payment to: , NINAETC Treasurer 2014 NINAETC Executive Committee For further information, call: (916) 920-0285; (800) 748-5259 – TTY; (916) 641-6338 – fax FOR NINAETC USE ONLY PAID BY: CK. AMT.: $___________ CK. NO.: #_______________ CASH $ PO AMT.: $___________ OTHER CREDIT CARD AMT.: $___________ AUTHORIZATION CODE: TOTAL AMOUNT REC’D: $______________ REC’D BY_______________ DATE:
NINAETC%20Call%20to%20Training_2014%20(fillable)3.docx