2009 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



United States Indoor Soccer Association,
1340 N. Great Neck Road, Suite 1272-142 | Virginia Beach, VA 23454-2268
Fax: (509) 357-7096 | Email:
pr@usindoor.com
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