Registration

NOTE: Make checks payable to: "Cozzi Productions, Inc."

Payment for Academy classes must be made at the time of registration.

Questions?

If you have any questions or problems with registration, please email Bob Cozzi directly.

Please complete one registration form for each attendee. (All information is kept confidential.)
An email confirmation is sent to you after this form is submitted.

Promotion Code:
Attendee Information:
First name:
Last name:
Your title:
Phone number	Ext:
Attendee e-mail:	EVENT EMAIL NOTIFICATIONS ARE SENT TO THIS EMAIL ADDRESS. DO NOT SPECIFY AN ADMINISTRATOR's EMAIL ADDRESS IN THIS SPACE
Administration e-mail: Specify when different from attendee email	Billing notifications are sent to the above email, if specified. Otherwise they are sent to the Attendee's email address.

PLEASE SELECT EVENT: Explain these choices	Select the Academy Location of your choice:
	Event pricing is subject to change without notice.
Billing Information:	Billing Address (required)
Company name (if applicable)
Address line 1:
(optional) Address line 2:
City:
State/Province (US/Canada only):
Postal/Zip Code:
Country (if not U.S.A.)

I have read and agree to the cancellation and refund policy
		NOTE: When you submit this page, your Invoice/Confirmation will be displayed. Please print that invoice. An email is also sent to you with a link to redisplay your invoice at any time. Payment can be paid directly from your invoice page using a credit card, or mailed to the address on the invoice.

Payment Instructions: When you press Submit, an invoice will be displayed in your web browser. To pay by check, please print out the invoice that appears on the next page and include a copy of it with your payment. To pay by credit card, please print the invoice and then press the "Pay Now" button. You will be prompted to enter your credit card information via the secure PayPal payment system.

If you need to enroll additional attendees, return to this page and fill out a separate form for each attendee.