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Sexual Assault Registration Form

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Member Information	Seminar Information
Member ID::	• Sexual Assault
Status:: Active	• December 02, 2010 -
Member Type:	• Radisson Hotel-Fossil Creek - $85 Sgl/Dbl 2540 Meacham Blvd., Fort Worth TX 76106 (817) 625-9911, Hotel Cut-off: November 15, 2010
Paid Thru:	• Sexual Assault Agenda

Event Contact	Pre-Registration Deadline
mschank@tcdla.com	• Monday, November 15, 2010

Reserve My Space | Materials

Item		Price
Book & CD
		Early Bird	Pre-registration	On-Site
	Member	$ 235.00	$ 235.00	$ 285.00
	Non Member	$ 410.00	$ 410.00	$ 460.00
CD Only
		Early Bird	Pre-registration	On-Site
	Member	$ 185.00	$ 185.00	$ 235.00
	Non Member	$ 360.00	$ 360.00	$ 410.00

Changes to Registration
You can contact us by phone at 512.478.2514 to make changes to your registration.

Cancellation Policy
To receive a full refund, cancellations must be received in writing two weeks prior to the seminar. Cancellations made within two weeks of the seminar will be assessed a 50 percent cancellation fee. Materials will be sent on CD only.

Onsite Payments
We accept check or credit card (MasterCard, Visa, Discover or American Express). No cash will be accepted onsite for registration, membership or publications.