PNNS Annual Conference Registration Form
Saturday, March 6, 2010

Please select the appropriate payment category and complete the following on-line form.  Make sure you submit the form and "Subscribe" for PayPal payment.  Registration cannot be guaranteed until payment is received.
NOTE:  This is our first trial with this on-line registration.  Please let me know if you have problems with it.  Brad

Payment Category:

$125    MEMBER
$150    NON-MEMBER
$  60    STUDENTS, FELLOWS, RETIREES, & PSYCHOMETRISTS

Contact Information:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Phone
E-mail

1. Please Click on "Submit Form"

 

2. Please select category and Click on "Buy Now" below to arrange PayPal credit card payment.

Category

Members $125.00 Non-Members $150.00 Students, Fellows, Retirees & Psychometrists $60.00

        

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For Questions, contact Brad Powell, PhD at bradpowell2@comcast.net or call (360) 701-3438
2118 Caton Way SW
Olympia, WA, 98502

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