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Registration Form

Behavior Seminar for Shelters, Rescues & Animal Control

Kelley Bollen

Springfield (DC /Fairfax- Arlington VA area), VA
Saturday & Sunday-September 10 & 11, 2016

First Name:
Last Name:
Business/Organization:
Address:
City:
State/Province:
Zip/Postal:
Work Phone:
Home Phone:
Email:
Method of Payment: Visa Mastercard Check in the Mail
Account Number
Expiration Date
Validation Code	Last 3 digits on signature panel.

*SEMINAR FEES*
GROUP RATES Groups of 3-4: $135 per person; 5 or more: $115 per person. For group discount registration & information call: 917-699-6440
*VIRGINA : Saturday & Sunday • September 10-11, 2016*
*"EARLY BIRD" UNTIL AUGUST 19*
	Saturday & Sunday	$155.00
	Saturday Only	$80.00
	Sunday Only	$80.00
*AFTER AUGUST 19*
	Saturday & Sunday	$175.00
	Saturday Only	$90.00
	Sunday Only	$90.00
*And don't forget...*
	Please send me more brochures to share with friends and colleagues.
	Notes/Special Requests:

An email confirmation will be sent to you for your files.

Please complete this registration form and mail in a check or provide us with your credit card number above. You can also phone or fax us your registration and payment information.
Please make checks payable to:

Petworkshops, LLC / Puppyworks
PO Box 938
New Paltz, NY 12561

email: events@puppyworks.com
phone: (917) 699-6440

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