Training Registration Form 3

Name*
First Last
Agency*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email*
Choose Training*
- HOTMA: An In-Depth Review of Programmatic Changes - Training with Exam: $600 Member
- HOTMA: An In-Depth Review of Programmatic Changes - Training ONLY - $450 Member
- HOTMA: An In-Depth Review of Programmatic Changes - Training with Exam: $700 Non Member
- HOTMA: An In-Depth Review of Programmatic Changes - Training ONLY - $550 Member
Cancellation Policy*
- I accept the Cancellation Policy
To receive a refund of your registration fees, written notice of cancellation must be received 30 days prior to the training; a $50 processing fee will be assessed. Cancellations received within 30 days of the training will not be refunded. The agency can send a substitute attendee if the original registrant can’t attend. No exceptions will be made.
Payment Method*
- Pay by Credit Card
- Invoice Me
Credit Card Number:
Expiration Date
CID Code
Billing Address
- Same as Above
- Different than Above
Credit Card Billing Address
Street Address City State ZIP Code
Name as it appears on card
Billing Contact Email*