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Get Your Book in Print Seminar
June 26-27, 2009
Dover, OH  

Date
First Name
Last Name
Street Address
Address (cont.)
City
State
Zip	-
Work Phone
Home Phone
E-mail
Web site

Check One	Beginner - not yet submitted a manuscript to an editor   Novice - some submissions but no sales, yet   Intermediate - some sales   Advanced - selling regularly
Registration Fee	Early Bird - postmark or register online by May 30 - $59   Regular - postmark or register online by June 17 - $69   After June 17 and at the door - $79    Registration fee includes lunch and coffee breaks.
Comments or Special Needs

Credit Card Information
	Charge my   VISA MasterCard Discover American Express    Total charge to card  $

	Card # (please include spaces)      Exp Date         V code from back of Card
	Name on card - First       Middle Initial
	Last Name
	Billing address (if different from above)
	Address
	City    State    Zip  -

Note: Before hitting submit, print a copy of this page for your records. Then hit "submit" to send your registration to us via a secure connection. You'll be taken to a confirmation page to acknowledge receipt of your registration.