ATPI Summer Workshop Registration Form

Please give us your School/Office address:
Your Name:
 School/Company Name:
School/Company Address:
City:
 State:
 Zip:
Work Phone:
 E-Mail Address:


Please give us your Home address:
Address:
City:
 State:
 Zip:
Home Phone:
  


Where would you like correspondence sent?
Home Address Work Address


Please tell us which class you would like to register for:


Please indicate the amount you have enclosed:
I am joining the Association of Texas Photography Instructors (ATPI) - $15
I am joining the Photo Imaging Education Association (PIEA) - $35
I am registering myself for the Summer Workshop for Instructors Only - $225
I have attended in the past and I'm bringing someone new - both of us are paying $175 each
  Total Amount Enclosed:

Print this form using the print command in your browser. Mail it, along with your check, to:
ATPI - P.O. Box 121092 - Arlington, TX 76012