Training Registration Form

Mediation and Collaborative Problem Solving

January 5-9, 2015 at CU Law School-Boulder, Colorado

·  $1,200 before November 14

·  $1,300 between November 15 and December 5

·  $1,400 after December 5

·  Special pricing :

o  Register 2 or more people from the same company/agency for an additional discount of $100/person.

o  $1,000 for CU Law School Alumni

You will be registered only after we receive your registration form and full payment. We will send confirmation of receipt to your e-mail address.

Payment:

All payments must be made in U.S. dollars via check, credit card or government purchase order.

Special Needs:

Please let us know if you have special needs that require class materials in a special format (such as Braille or large print) or other accommodations at least three weeks before the seminar begins.

Cancellation:

If you cancel up to 30 business days prior to the program, we will refund tuition, less a $150 processing fee. Cancellations made between 29-14 days prior to the program will be subject to a 50% cancellation fee. No refunds within 13 days of the program date. CDR reserves the right to cancel any program at any time. * Full tuition refunds will be made for programs cancelled by CDR.

*CDR is not responsible for non-refundable travel and lodging arrangements.

NAME:

PROFESSION/OCCUPATION:

COMPANY/AGENCY:

ADDRESS:

CITY/STATE/ZIP/COUNTRY:

PHONE: EMAIL:

Contact information will be shared only with other participants in your seminar, unless otherwise requested.

PAYMENT INFORMATION

Mediation and Collaborative Problem Solving

January 5-9, 2015 at CU Law School-Boulder, Colorado

Please charge the $ tuition to my credit card: (circle one)

MasterCard Visa American Express

Card: Expiration date:

Name on card:

Billing Zip Code:

Signature:

- OR -

I am enclosing a check or money order in the amount of $

Please make check payable to CDR Associates ($U.S.) Check #

- OR -

Government Purchase Order # for full tuition is attached.

Additional Comments:

Mail: Fax: Phone: E-mail:

CDR Associates 303-442-7442 303-442-7367

3050 Broadway, Suite 300 (Credit Cards Only) (Credit Cards Only)

Boulder, CO 80304