Online Registration for
Referendum Planning – A Systems Approach
February 12, 2014

You must register for this seminar by February 10, 2014.
You may register by mailing a printed copy of the completed registration form below, along with a check for total fees or your credit card information to:
Speer Financial, Inc.
Attention: Mary Johnson
One North LaSalle Street, Suite 4100
Chicago, IL 60602
Please make check payable to Speer Financial, Inc.

You may also register by printing and completing this form, faxing it to Mary Johnson at 312-346-8833 or by e-mailing a scan to mjohnson@speerfinancial.com. If paying by check, you will also need to mail a printed copy of this completed registration form along with a check for total fees to the address shown above.

PAYPAL PAYMENT OPTION You must still complete and submit the registration form below, but you may use this area first to pay your fees through our secure PayPal shopping cart.
Register: One $75.00 Two $150.00 Three $225.00 Four $300.00 CEU's $5 Each (Parks Only) One $5.00 Two $10.00 Three $15.00 Four $20.00

Online Registration: (* = required)

**Seminar Fees: $75 per attendee. CEU's $5 each (Parks Only)
Name of Firm*:
Address*:
City, ST*:
Zipcode*:
Phone*:
E-mail address*:

	Referendum Seminar Registration	CEU's @ $5 (Parks Only)	Total $
Attendee 1: Title:
Attendee 2: Title:
Attendee 3: Title:
Attendee 4: Title:

If paying by Credit Card:
Type:		Visa    Mastercard    Discover
Name on Card:
Card Number:
Expiration Date:
Vin# back of card:
Billing Zipcode:
Anticipated Referendum:    Spring 2014    Fall 2014    Fall 2015    Future
Referendum Purpose:    Capital    Operating    Both    Other
I am unable to attend, but please have a representative from Speer Financial, Inc. contact me       regarding a future referendum/bond issue.
Membership (please check one):    IASA    IPRA    IAPD    ILA
Each Association receives a rebate for each member attending each workshop

Click here for Seminar Agenda and Information