Name: _____________________________________________________________

Organization: ________________________________________________________

Address: ___________________________________________________________

City/State/Zip: _______________________________________________________

Telephone: _____________________ Fax Number: __________________________

E-mail: _______________________________

Seminar Attending: ____________________________________________________

Seminar Date: ___________________

MLK Day Current Issues Seminar: OACDL, GCCDLA Member: $80 _____
Non-Member: $95 _____

Regular Seminar Cost: Member: $170 _____ Non-Member: $225_____

Death Penalty Seminar Cost: Member: $325 _____ Non-Member: $375 _____

Juvenile Law Seminar Cost:

1-Day Member: $130 _____
1-Day Non-Member: $175 _____
2-Day Member: $200_____
2-Day Non-Member: $250_____

Charge My: MasterCard _____ Visa _____ Discover _____

Credit Card Number: ______________________________ Exp. Date ___________

Authorized Signature: __________________________________________________