March 27 2004, 1:00 - 5:00 p.m. Mafly Auditorium, Herrick Hospital, 2001 Dwight Way, Berkeley CA
Registration Form (For Payment by Check or Money Order) If paying by Visa/MC click here instead.
Please fill out and submit one form for each person who will attend.
First name: Last name: Firm or agency: Street address: City: State: Zip or Postal Code: Country (if not USA) Telephone numbers: Email address:
Yes, I want four CAADAC CE Units
Please make out check or money order in the amount of $20 per person without CE Units, $40 per person with CE Units. Make payable to "LifeRing." Print out a copy of this page and enclose it with your check/MO. Mail to:
LifeRing Service Center 1440 Broadway Suite 312 Oakland CA 94612 Telephone 510-763-0779
Telephone 510-763-0779
Click here if you prefer to pay online using your Visa/MC.
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