Registration Form

1040/540 Tuneup - 2010
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Please use a separate registration form for each attendee. Photocopies are OK.

Name: __________________________________________________________________________

Address: ________________________________________________________________________

              ________________________________________________________________________

Telephone: _____________________    Fax: __________________

EA  ___CPA  ___ PA  ___ CTEC  ___ ATTY ___     Certificate/Registration # _________________

I will attend location # B__    at ____________________________________________________
                                                                                                                     (City)

I was referred by: _________________________________________________________________

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___ Workshop Fee -  $190  (Early Bird -  $175-Until 10-31-2010)  (Price At Door -  $200)
___ Self-Study Course -  $165

___ Enclosed Is My Check made payable to BRASS TAX PRESENTATIONS

___ Credit Card Authorization for my   ___VISA CARD    ___MASTERCARD

________________________________________________________________
                                                      (Billing Name)

________________________________________________________________
                                                      (Billing Address)

Card Number _________________________________________   

Expiration Date ________________

Signature _________________________________________________

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Send Registration Form to:

Brass Tax Presentations
PO Box 28147
San Diego, CA 92198

Phone (800) 388-8404 PIN 1040   or    (858) 487-2553
FAX (858) 487-8245

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