NFSA Live On-Line Seminar Registration Form

NFSA Live On-Line Business Seminars
Registration Form

**Please select the seminars you wish to participate in:**
Smart Hiring in the Construction Industry - December 18, 2008 To view seminar descriptions click HERE!

NFSA Member Cost Structure ($125 per session)

NON-NFSA Member Cost Structure ($250 per session)

A late registration fee of $25 will be added if order is received less than 24 hours prior to the seminar.
Participant will receive a verification email upon signing in. Participant certificates
are also available for $25 each for members and $50 each for non-members.
Cancellation Policy:
You may receive a full refund, upon cancellation five full days prior to the seminar date.
You may receive a 50% refund, upon cancellation up to three days prior to the seminar date.
Call (845) 878-4200 ext 133 to cancel or for further information.

Methods of payment:
1) Fill out this form and mail payment to:
National Fire Sprinkler Association
Internet Seminars
40 Jon Barrett Road
Patterson, NY 12563
2) Print this page and fax it with your credit card information to (845) 878-4215
3) Submit Credit Card On-Line - This page is fully secure and encrypted!
4) or by phone: Call Dawn at (845) 878-4200 ext. 133
*Note: Username and Password will not be sent until payment is received.

"*"=Required field

Name:*
Company:*
Address:*
City/State/Zip:*
E-mail:*
Telephone:*
Fax Number:
Are you currently a member? *YesNo
Membership Number (if applicable):

Contractor/Installer, Contractor/Maintenance & Journeymen Fitters operating in the
States of Wisconsin and Florida, please provide the following to obtain state CEU credits:

License Number:
Mother's Maiden Name:

Is cardholder address the same as above? YesNo
Cardholder Name:
Cardholder Address:
Cardholder City/State/Zip:

Type of Credit Card: *Visa MasterCard Amex Discover
Credit Card Number: *
Expiration Date (MM/YY): *
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