Course Registration

March 20–22, 2012
University of Washington campus, Seattle, WA

Course Fee

$1250 (USD)
Groups of 5 or more from the same organization receive a discount of $100 off the per-person fee. Please email Ellen Barker at nelle@uw.edu for instructions.

Each registrant must complete a form with his or her name.

Title	Dr.   Mr.   Ms.
First Name*
Middle Initial
Last Name*
Job Title
Organization*
Street Address
City*
State or Province*
Country*
Zip or Postal Code*
Telephone*
Fax
Email Address*

 * Indicates required information.

Payment Method

Register electronically using a VISA, MasterCardor American Express to speed up the enrollment process for. You may also print and mail this form if you do not wish to submit it electronically. Mailing instructions can be found below.

Credit card (VISA, Mastercard, or American Express only)
Check (personal or cashier, payable to University of Washington) / Money Order
Wire transfer

Contact Information

Call:	206-543-0299
E-mail:	nelle@uw.edu
Mail:	Ellen Barker University of Washington Box 352600 Seattle, WA 98195-2600 USA

Refund Policy

If you enroll and cannot attend, a 100% refund of the registration fee less a $35 processing fee will be granted if requested two weeks prior to the course. If you cancel within two weeks of course start, you will receive a 50% refund of your tuition, less the $35 fee. No refunds will be granted to registrants who fail to cancel prior to the opening of the course. If you are unable to attend, you may send another person in your place.

Terms & Conditions

AMTAS reserves the right to cancel this program in the event of low enrollment or other circumstances beyond its control. The total amount of liability of the University will be limited to a refund of the attendance fee. Attendees who incur any expenses (including but not limited to nonrefundable airline tickets) in anticipation of attending the program do so at their own risk. Submission of this registration form acknowledges acceptance of these provisions.

The University of Washington provides equal opportunity in education without regard to race, color, creed, religion, national origin, gender, sexual orientation, age, marital status, disability or status as a disabled veteran or Vietnam era veteran in accordance with University policy and applicable federal and state statutes and regulations.

The University of Washington is committed to providing access and reasonable accommodation in its services, programs, activities, education and employment for individuals with disabilities. To request disability accommodation, contact the Disability Services Office at least ten days in advance of the event: 206-543-6450 (voice); 206-543-6452 (TTY); 206-685-7264 (fax); dso@u.washington.edu.

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