Seminar Sign Up Form:....

MONDAY, OCTOBER 24, 2011-CT

CROWN PLAZA, 100 BERLIN ROAD, CROMWELL, CT 06416

WEDNESDAY, OCTOBER 26, 2011-NH

COURTYARD MARRIOTT, 1000 MARKET STREET, PORTSMOUTH, NH 03801

9:00 AM to 12:00 PM (followed by complimentary lunch)

 

Please provide the following contact information:

 

Name
Title
Organization
Work Phone
FAX
E-mail
CT Seminar
NH Seminar 
          
You can also print out this form and fax to 860-621-3684
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