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Get Your Book in Print Seminar
March 29, 2008
Allentown, PA  

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 March 1 - $45   Regular - postmark or register online by March 22 - $55   After March 22 and at the door - $65    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  -

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