SEMINAR REGISTRATION FORM

Yes, include me: ___________________________________

Enrollment fee: $________ per person

I will be attending: Date ____________________________________ 8:00 a.m. to 5:00 p.m.

Location ___________________________________________________
Name __________________________________________  Rank _________
Agency/Dept. ____________________________________________________
Address ________________________________________    Suite _________
City, State, Zip ___________________________________________________
Telephone ____________________________________   Ext. _____________
E-mail address __________________________________________________
Payment must be made before course  -  Please send P.O.'s with registration

Payment Amt. $__________  Check # _____________  Purchase order # ______________


Signature::_____________________________________________ Date ____________
Mail / Fax registration to:
Ryan & Assoc. Public Relations
P.O. Box 62651
Phoenix, Arizona USA 85082
Office: 602-840-2959
Fax to: 800-852-7039
www.policemediarelations.com

Cancellation does not affect the registrant's financial responsibility unless we receive notice 15 days prior to the start of the course. This copyrighted course contains exclusive confidential material developed by Chris Ryan and Ryan & Assoc. Public Relations. Audio taping, video taping and/or recording by any other means other than that done by the presenter in conjunction with the course is strictly prohibited.  Thank you for your cooperation.