To register for the Spring 2009 workshop, please fill out the form below.
At the end of the form, click "submit") ---

Name:              
Address:           
City:                  State:    Zip:   
Work Phone:     

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Choose a category from the list:

        Member $175.00 Non-member & Become a member $225.00 Student (includes member dues) $125 Non-member $250.00

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Enter a donation amount to the CGPS Scholarship Fund
(please do not include $ sign or decimal point - e.g., 123 = $123.00 )

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I would like to attend but need scholarship in the amount of
(please do not include $ sign or decimal point - e.g., 123 = $123.00 )

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Please choose Credit Card type

        Visa MasterCard

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Please Enter Credit Card Number:

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Please Enter Expiration Date (2 digit month / 4 digit year):

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