Mail-In Registration

Keith Vincent, CSR
Tel. +1 (713)523-6345

e-mail

“Simply Magic”
A Small Group Workshop by Keith Vincent on Total Eclipse

Earn up to 10 CE Hours (including 3 Hours in Rules/Ethics)
Approved Texas Judicial Branch Certification Commission (Program CRC2016132)
Fulfills ALL your Texas continuing education requirements

Sign Me Up: ___ Houston - October 1, 2016
                           La Quinta Inn - Galleria - 1625 West Loop South, Houston, TX 77027
                   
Name: ___________________________________
CSR No. ________________

Address: ___________________________________________________

City: _______________________________  State: _______ Zip:_______

E-mail: ___________________________________________

Telephone Numbers: __________________________________________

Registration Fees (For “Early Bird” discount, register at least 1 week in advance!)
     Saturday:  “Simply Magic” Total Eclipse 5  (.7 CEU)
         ___ Reporter:  $275     ___ Scopist:  $200     ___ Student:  $125
        
“Early Bird” fees (registering at least 2 weeks in advance)
         ___ Reporter:  $250     ___ Scopist:  $175     ___ Student:  $100
   
     Saturday Evening:  By the Rules and Automatic Indexing (.3 CEU, including Ethics)
         ___ Reporter:  $150     ___ Scopist:  $100     ___ Student:  $75
        
“Early Bird” fees (registering at least 2 weeks in advance)
         ___ Reporter:  $125     ___ Scopist:  $75     ___ Student:  $50

     All Day Saturday:  Fulfills all your Texas CSR requirements (1.0. CEU, including Ethics)
         ___ Reporter:  $375     ___ Scopist:  $250     ___ Student:  $175
        
“Early Bird” fees (registering at least 2 weeks in advance)
         ___ Reporter:  $350     ___ Scopist:  $225     ___ Student:  $150

Method of Payment:
___ Check or Money Order                          

Amount: ________

Make Checks Payable To:
    
Keith Vincent, 1910 Ottawa Lane, Houston, Texas 77043        
     For more info, call Keith (713-523-6345)

Seating is Limited.  Call to check availability!

Cancellation Policy:
A refund will be given (minus $35.00 administration fee)
for cancellations made at least two weeks prior to the date of the seminar.
NO REFUND, CREDIT, OR TRANSFER thereafter.
However, your registration is transferable for someone else
to attend the seminar in your place.