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PBI: Registration and Order Form
Print this form for mail or fax orders ONLY.
(Please Note: Fax orders must be paid by credit card.)
Customer Information | Register for Course Online | Order Publications Online
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|
PBI: Registration and Order Form
Print this form for mail or fax orders ONLY.
(Please Note: Fax orders must be paid by credit card.)
Customer Information | Register for Course Online | Order Publications Online
|
To Register for PBI Seminars:
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| Seminar Title | Location and Date/Session |
| 1. | 1. |
| 2. | 2. |
| 3. | 3. |
| 4. | 4. |
| ____PBA Member | ____ Paralegal |
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____County Bar Member
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____ Judicial |
| ____ CPA | ____ Other _________________ |
Customer Information:
| Name__________________________________ | Atty. No._______________________________ |
| Firm __________________________________ | Address*_______________________________ |
| City___________________________________ | State___________________________________ |
| Zip____________________________________ | Phone__________________________________ |
| County_________________________________ | Fax____________________________________ |
| E-mail Address___________________________ | |
| *Note: Please include street address. UPS will not ship to a post office box. | |
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To Order PBI Products:
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| Qty. | Item No. | Title | Price | Amount |
| 1. | 1. | 1. | $ | $ |
| 2. | 2. | 2. | $ | $ |
| 3. | 3. | 3. | $ | $ |
| 4. | 4. | 4. | $ | $ |
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Shipping
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$ 6.00 | |||
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Subtotal
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$ | |||
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Add 6% Pa. Sales Tax
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$ | |||
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TOTAL
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$ | |||
Payment Information:
A check for $__________ is enclosed. (Fax orders must be paid for by credit card)
Charge my: _____ MasterCard _____ VISA _____ American Express | Amount: $_______
Credit Card Number ______________________ Expiration Date ____/____
Authorized Signature ________________________________________________