Please fill out the following:

Name ________________________________________________________

Address ______________________________________________________

City _________________________________________________________

State __________________________ Zip ___________________________

Phone _________________________ Fax ___________________________

Fill in the dates and location of the session you plan to attend:

______________________________________________________________

ASAA SEMINARS WILL BE HELD AT THE LOCATIONS LISTED BELOW:

Denver, CO - March 8-12, 2006
Dallas, TX - March 29 - April 2, 2006
Pittsburgh, PA - May 17-21, 2006
Sioux Falls, SD - July 19-23, 2006
Nashville, TN - August 16-20, 2006

_____________________________________________________________

Check the seminar fee that applies to you:

$595 Member Fee

$650 Non-Member Fee

Check the method of payment enclosed:

Check or Money Order

Visa

MasterCard

Name on Card _________________________________________________

Card # _______________________________________________________

Expiration Date ________________________________________________

Signature _____________________________________________________

Once you have completed this form, mail it and your seminar fee to:

ASAA
P.O. Box 186
Twin Falls, Idaho
83303-0186