United States Indoor Soccer Association | 2008 Teleseminars Registration Form

Name of Facility: Date Opened:

First Name: Last Name:

Address:

City: State: Zip:

Telephone: (Day) (Evening) Fax:

E-mail Address: WebSite:

I would like to register for the following teleseminar(s):


	Building a Quality Referee Program Speakers: Mario D'Agostino and David Simmons, USIndoor Referee Instructors January 20, 2009 1:30 pm - 2:30 pm EST Price per telephone line: $49.00

Your Current Total:

Payment:

	I am sending a check to USIndoor at the following address: USIndoor Teleseminar Series, 1340 N. Great Neck Road, Suite 1272-142, Virginia Beach, VA 23454-2268.

	I would like to pay by credit card