Seminar Venue Information

IEPs and 504 Plans: A Legal Compliance Guide
DoubleTree by Hilton Columbia
2100 Bush River Rd.
Columbia, SC 29210
USA
 
From 2019-12-09 to 2019-12-10
Price/person: $575
Seminar Code: 1090163 / 583449

Registrant Information

1) Mr./Ms. ___________________________________

   Job Title___________________________________

   Email_____________________________________

2) Mr./Ms. ___________________________________

   Job Title___________________________________

   Email_____________________________________

3) Mr./Ms. ___________________________________

   Job Title___________________________________

   Email_____________________________________

4) Mr./Ms. ___________________________________

   Job Title___________________________________

   Email_____________________________________

5) Mr./Ms. ___________________________________

   Job Title___________________________________

   Email_____________________________________

6) Mr./Ms. ___________________________________

   Job Title___________________________________

   Email_____________________________________
 

Company Information

Company Name ___________________________

________________________________________

Company Address ________________________

________________________________________

City ___________________________

State ____________

Zip ______________

Phone ______________________________

Fax ________________________________

Billing Information

Bill My Company   or   Pay by Credit Card

Billing Address (or address on credit card)

________________________________________

________________________________________

City ___________________________

State ____________

Zip ______________

Attn To (or)
Card Holder ______________________________

PO Number ______________________________
 

Credit Card Information

Card #___________________________________

Expiration ___ / ___               C V V ___________

Signature ________________________________