November 16 Registration Fax to: (608) 204-9818 Mail to: 2830 Agriculture Dr.
              Madison, WI 53718

Personal Information
Full Name:
Title/Position:       Company/Affiliation:
Address:
City: State: Zip:
Phone: Fax: Email:

Which activities will you be attending? (check all that apply)
AM Workshops 9:30 - 11:45 How to Jumpstart Your Training Design-- Deborah Spring Laurel, Laurel and Associates, Ltd.
PM Lunch, Keynote & Workshop 12:00 - 2:00 Train Like a Pro, Even When You're Not! -- Deborah Spring Laurel, President of Laurel and Associates, Ltd.
Registration Fees
AM Workshops Only PM Lunch, Keynote & Workshop All Sessions
__ $30 GMA SHRM or ASTD Member __ $35 GMA SHRM or ASTD Member __ $55 GMA SHRM or ASTD Member
__ $40 Non Member __ $40 Non Member __ $70 Non Member
__ $10 Students __ $10 Students __ $20 Students
Method of Payment - Pre-payment required for non GMA SHRM/ASTD members.
Total to be charged: _________ Mastercard       Visa      
Credit Card Number:     Exp. Date:
Three digit verification number (on back of credit card):
Name as it appears on card:
Billing Address for Credit Card:

No refund will be given for cancellations after noon on Friday, November 12, 2004.
GMASHRM Headquarters
2830 Agriculture Dr.   ::   Madison, WI 53718   ::   Phone: (608) 204-9814  ::   Fax: (608) 204-9818   ::   Email: chapteradmin@gmashrm.org
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