JLI Registration

COURSE DATES:

Option 1:
Wednesday, June 10
Wednesday, June 24

Option 2:
Thursday, June 18
Thursday, June 25
Full Name*
First Name Last Name
Phone Number*
E-mail*
Number of attendees* $60/person
I/we will attend*

Option 1 - the Wednesday evenings courseOption 2 - the Thursday mornings course
Total

$0.00

Payment

Credit Card

We accept Visa, MasterCard, American Express, Discover
Credit Card Number	Security Code
Name on Card
Expiration Month	Expiration Year

Billing Address

Street Address

City

State / Province

Postal / Zip Code

Country

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