speaker University

How to register for Speaker University

Print the form below, complete and fax to the office (630-208-4935). Next registration open is for session starting in October 2008.

Or mail to National Speakers Asssociation-Illinois Chapter
2306 Brookway Drive, Geneva, IL 60134

Cost: $549.00

Or mail to National Speakers Asssociation-Illinois Chapter
2306 Brookway Drive, Geneva, IL 60134

Name:_____________________________________________

Title: _____________________________________________

Company: _________________________________________

Address: __________________________________________

Phone: ____________________________________________

Fax: ______________________________________________

E-mail (required):____________________________________

__ I have paid online

__ I will mail a check

******

__ I would like to fax a credit card payment

Visa ____ MasterCard ___

Account # __________________________________________

Expiration Date ____________ Name on Card: ______________

Signature (required with fax):

_____________________________________________________

Billing Address if different than above: