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Institutions Forum Registration Get the Flyer If you are a professional working in a Treatment or Correctional Facility PLEASE CLICK HERE There is no cost for registration if you work in the fields of Corrections or Treatment and are not a Member of Alcoholics Anonymous. Please complete this form for professionals if this criteria applies to you. You may register for yourself and your coworkers with this form. Otherwise Please complete this form for registration. Online payment for registration will be completed thru PayPal. A transaction fee of 3.75% of the total plus 49¢ per transaction will be added to your registration total. Your registration package will be waiting upon your arrival. Registration and payment confirmation will be sent to you via email. For Questions please contact us through our "Contact Us" page. We look forward to seeing you there. If you are registering for more than one person please make sure the credit card information matches the contact information for the first person registered. If you are using another credit/debit card, the payment information may be changed when you are transfered to the PayPal site.
Registration and Credit/Debit Card Information
Email:
First Name:	Last Name:
Address:	Apt or Suite:
City:	State:	Zip:	Phone:
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How many people are included in this registration (max 4)? You will add their info next.	One Two Three Four


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