Dario Nardi Workshop

April 7

$100 Member, $130 Non-Member includes one year membership 

       Student (full time Graduate) $90 includes one year membership

      Student $70  Workshop only  

Please type or print the following information:

Name_____________________________________________________

Type Preference_____________________________________________

Mailing Address______________________________________________

Company____________________________________________________

Email Address________________________________________________

Home Phone_________________________________________________

Business Phone_______________________________________________

Credit card #___________________________   Exp. Date____________________

Visa, Master Card and Discover accepted

Name on Credit Card__________________________________________________

Return this form to: Larry Gabbard

8261 Cooper River Dr., Colorado Springs, CO  80920

Make checks payable to:  RMAPT

Fax to: 719-593-1858

Membership Questions? Contact larrygab@adelphia.net