Title IX Tuesdays with Val and Debbie – Registration

Session Date: Tuesday April 15
Include The Manual*
- No ($250)
- Yes, include the manual ($500)
Personal Information
Full Name*
First Last
Title
Institution Name
Email*
Phone*
Shipping Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Billing Information
Billing Address*
Street Address Address Line 2 City State ZIP Code
Credit Card*

Discover
MasterCard
Visa
Supported Credit Cards: Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Total
$0.00