Fill out and then print out this form, or print out and handwrite in the blanks. Then just fax or mail.
____ x $395 = $____ Full Summit
____ x $150 = $____ One Day Only (select below)
____ x $495 = $____ Full Summit
____ x $185 = $____ One Day Only (select below)
__ Check (made payable to Nonprofit Risk Management Center) __ Credit card
| Name on card | |
| Organization | |
| Street Address | |
| City | |
| State | Zip |
| Telephone | |
| Type | __ Visa __ MasterCard __ American Express |
| Number | Expiration |