NAIA ZAPP? Digital Viewing Opportunity Registration
October 12, 2005
1:00 - 4:00 PM

Pat Barrett's studio
2521 Madison NE, Albuquerque, NM

Name: ________________________________________________
Address: ______________________________________________
City, State, Zip: _________________________________________
Telephone: Day/Evening/Cell _____________________________
Email: ________________________________________________

Are you a current NAIA member? Y___ N___
If you are not a current NAIA member and wish to join, you may do so here:

Seminar Fees: Check those that apply.

All attendees:

___ $15.00

Payment methods:

Check: Fill out and mail this Registration form, along with your check
payable to NAIA, to the address below.
Credit Card: Fill out this this Registration form, including your credit card
information, and mail to the address below.

Credit Card
Name on card: __________________________
Credit card: _____________________________
Expiration: _____________________________

NAIA Digital Viewing Opportunity
c/o Ardath Prendergast
72 Douglas St.
Homosassa, FL 34446

Space is not guaranteed until your payment is received.
Back to Seminar Credit Card Registration