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REGISTER FOR January 30, 2012 USPAP Class
Please Choose One
(required)
NAIFA Member
NOT an NAIFA Member
Method of Payment- Credit Card Only
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Online Credit Card (add $6.00)
NAME:
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ADDRESS:
CITY,STATE,ZIP:
CONTACT TELEPHONE:
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CONTACT EMAIL:
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2nd Registrant
3rd Registrant
4th Registrant
5th Registrant
Submit below when Completed