| PRINT OUT THIS PAGE AND BRING FOR AT-THE-DOOR REGISTRATION |
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REGISTRATION FORM |
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| NAME: | __________________________________________________________________________ | ||
| ORGANIZATION/FIRM: | __________________________________________________________________________ | ||
| ADDRESS: | __________________________________________________________________________ | ||
| CITY: | ___________________________________________ | ||
| STATE: | ___________________________________________ | ||
| ZIP CODE: | ___________________________________________ | ||
| EMAIL: | ___________________________________________ | ||
| STATE & BAR NO. FOR CLE: | ___________________________________________ | ||
| I CONSIDER MYSELF (circle one): | BEGINNER | INTERMEDIATE | ADVANCED |
| Payment is via cash, check (payable to the National Immigration Project), or credit card. | |||
| Credit Card Authorization | |||
| ___ I would like to pay by credit card (Visa, MasterCard, Amex, Discover) | |||
| Card Number: | ____________________________________________ | ||
| Expiration Date: | ____________________________________________ | ||
| Name and billing address on credit card, if different from above: |
_____________________________________________________________________________________ |
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| Signature: | ____________________________________________ | ||
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The National Immigration Project of the National Lawyers Guild certifies that the Florida State Bar has approved this activity at an ADVANCED level for 7.5 CLER credits (7.5 50-minute hours/6.25 60-minute hours) under Course Number 1956-6. All proceeds of the seminar support the work of the National Immigration Project of the National Lawyers Guild, a network of lawyers and legal community workers engaged in immigration law and practice. The Project works to diminish discrimination against the foreign born and to preserve, defend and extend the rights of all immigrants in the United States. The site is wheelchair accessible. |
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