JEAN MUNROE ASSOCIATES - Training Registration Form

Name:

___________________________________

BPR# if attorney:

Organization:

___________________________________

Address:

___________________________________

City, State, Zip:

___________________________________

Telephone/Facsimile:

___________________________________

E-mail address

___________________________________

Course Name

Date

Location

Rule 31 Family Mediation

 

Tuition - $1445

$100 discount if sign up 30 days early

Total $____________

Rule 31 Civil Mediation

Tuition $1245

$100 discount if sign up 30 days early

CLE for attorneys

40 general/5 ethics for family

34 general/5 ethics for civil

Credits @ $1.00 per hour

_______hrs gen. Total $____________

_______hrs ethics Total $____________

Total Tuition/CLE Fees

Total $ _____________

Check Enclosed Payable To: Jean Munroe

Please charge my credit card:
____ VISA            ____ MasterCard          ____ Am Express
Card # __________________________________
Expiration Date: ___________________________

Signature ___________________________________________________________________

Please print this registration form and mail or fax to:
Jean Munroe
P. O. Box 14036
Knoxville, TN 37914
Fax: 865-637-4292