Workshop Registration Form
Preregistration is required due to limited
enrollment.
Three ways to register:
CALL toll
free weekdays (800) 358-READ (7323), 9 AM to 2 PM PST or leave a message
FAX this registration form and credit card
information to (310) 257-8482
MAIL this registration form and check to:
Total Reading Association, P.O. Box 54465, Los Angeles, CA 90054.
Workshop City
____________________________ Date ____________
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Registration Fee
1-Day $175 • 2-Day $295
FREE Phonogram
Poster with Pre-registration.
20% Discount for Group Registration of
5 or more.
Cancel at any time up to 2 weeks before the
workshop date. Thereafter the fee is not refundable but you may
receive a credit to a future workshop or your choice of Total
Reading workshop materials.
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 PO#
_________________
Enclosed is a check for $ __________ dated ___________
Charge my credit card
number _______________________________
Visa
MasterCard
Expiration Date ______________ Authorized Charge $ ________
Signature ________________________________________________
I am interested in college credit.
(College credit checks written the day
of the
course to the college.)
I am interested in the Pilot Program.
| Name |
________________________________________________ |
| Home Address |
________________________________________________ |
| City, State, Zip |
_______________________________,
______ _________ |
| Home Phone |
( )
________________________________________ |
| Work Phone |
( )
________________________________________ |
| Grade Level |
________________________________________________ |
| School/District |
________________________________________________ |
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DEDUCT
50% OF YOUR WORKSHOP FEE FROM YOUR TAXES -
One half of your Workshop fee is deductible from your itemized tax return as a
contribution to the non-profit Total Reading Association. You will receive a notice
at the Workshop of your contribution.
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