I want to get certified as a Government Administrative Manager!

I don't want to get certified, but register me for the course(s) listed below

Name:

Title:

Organization:

Address:

Address (cont'd):

City:

State:   Zip:

Phone:

Fax:

E-mail:

Please enter the code and title for each course in which you want to enroll. Doing so will ensure you are registered for the corect course and the correct dates. Codes can be found near the top of each course's web page.

Course Code

Course Title

Tuition

$595*

$1095*

$1095

$1095

$1095

*Note: By enrolling in all three programs at once, your total tuition will be $1785 -- a savings of $1000!

How did you learn about the program?

Web site (no other contact) Brochure in Mail Faxed Flyer E-mail or phone call from James Simpson Electronic Newsletter

If you selected "brochure" or "faxed flyer," please find the
"Priority Code" written near your name on the brochure or fax and enter it here.
Please enter that code here:      *REQUIRED

Credit Card Number:

Expiration: 

Name on Card:

Please call me, I don't want to send my credit card information over the Internet

Cancellations: A $150 service fee will be charged on cancellations received less than three weeks from the date of the event. A credit memo will also be sent reflective of that amount, which can be used for a future Performance Institute conference.