May 2017

Page 18

daybar.org/cle

DBA CLE Registration Form Member

Passport Holder

NonMember

CLE Seminar #(s) __________________________________

Name(s) ____________________________________________________________________________________ Firm/Company ______________________________________________________________________________ Address ____________________________________________________________________________________ City, State + Zip______________________________________________________________________________ Phone _____________________________E-mail ___________________________________________________ Enclosed is my check in the amount of $______________ (made payable to the Dayton Bar Association) Please charge my credit card the amount of $__________

Visa

MasterCard

Discover

Am. Express

Card Number ____________________________________ Expiration Date______/______CVV Number_______ Cardholder Signature__________________________________________________________________________ 18

Dayton Bar Briefs May 2017

937.222.7902


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May 2017 by Dayton Bar Association - Issuu