I would like to register for the Hispanic Career Development Workshop entitled:

Date(s) of Session:

Cost:  $ per participant   *No. Participants   *Total: $

Location of Session:

*Name Title
Company
*Address
*City *State *Zip
*Phone FAX
*E-mail

To Register:     Complete and submit this form for instant registration (Button Below).
    OR:                    Complete, print, and fax form to 972-386-8378. 

THEN:                (1) Make check payable to: HCDR c/o VerbaCom

                                (2) and mail check to:

                                     VerbaCom
                                     7920 Belt Line Road, Suite 610
                                     Dallas, TX 75254

To Guarantee Registration, check must be received 48 hours before event,
or call 972-386-8372 to guarantee seat with a credit card, and bring your check to the event.
All payments must be received by day of event. Credit card payment will also be accepted
(processed through VerbaCom).

 Authorized Signature:________________________________   Date:_____________
Please add me to your contact list
Please add my organization to your contact list:
   

Please call (972) 386-8372 for more information,
or look at our website at: www.verbacom.com/roundtable/rtlatest.html
for directions to the event and the latest updates.