Domestic Case Management Training
Registration Form

Registration Fee (includes lunch) (circle category):
$180 - Both days paid by July 30
$120 - One day paid by July 30 Circle day: Thursday | Friday
$200 - Both days after July 30

Registrations are due by Friday, July 30, 2010.

Print and complete this page. Mail with your check (payable to: Washburn University School of Law) or credit card information to:

Washburn University School of Law
Attn: Donna Vilander
1700 SW College Ave.
Topeka, KS 66621-1140
(Phone: (785) 670-1105; Fax: (785) 670-1024)

Name:     _____________________________________________

Firm/
Business: _____________________________________________

Address:  _____________________________________________
          Street

          ______________________________________________
          City               State                 Zip

Phone:    ______________________________________________

E-mail:   ______________________________________________

Lunch:    Vegetarian: ________  Regular: ________

Credit Card (circle one): MasterCard, Visa, Discover

Card No: _______________________________  Expiration ____________

Signature: ___________________________________________

Cancellations:
If you cannot attend the seminar, you may send a substitute. If you cancel your registration at least two (2) business days prior to the seminar, your registration fee will be refunded. After that date, non-attending registrants will receive the course materials. Please allow two weeks for delivery. The sponsors reserve the right to cancel this seminar and return all fees.

Assistance for Special Needs:
If you require any special services or auxiliary aids to assist you while attending the program, please contact Donna Vilander at (785) 670-1105.

Domestic Case Management TrainingRegistration Form

Domestic Case Management Training
Registration Form