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		American Institute on Federal Taxation 2010 Printed Registration Form


	Full Name: ___________________________________________________________ Firm Name: ___________________________________________________________
	Office Address: _____________________________________________ City:_____________________________State: __________Zip: _______________
	Office Phone: ______________________________ Office Fax#: _______________________________
	Email Address: _________________________________________
	Profession (CPA, ATT'Y, OTHER): _____________ Alabama State Bar #: _____________ Alabama CPA Certificate #: _____________ Type of continuing education credit (CPE, CLE, or Both): ___________
	Registration Type: _____ Full 3-Day Institute $475.00 _____ Single Day Institute $250.00 _____ Book Only Order $150.00
	Specify date for single day registration:_______________ I will be attending the free sponsored luncheon on Thursday, June 24: ______yes _______no
	Total amount of check sent: _______________

	The fee is $475.00 for the full registration (3-day Institute) or $250.00 for any one single day. The $475.00 fee covers the Institute, three Continental Breakfasts, one catered luncheon, and the Material Program Book. Any single day registration is subject to cancellation in the event of capacity demand for full registrations. You may purchase the Material Program Book, without registration, for $150.00.
	In order to make multiple registrations for a firm, please state the firm's name in the registration application and list the names of the persons who will attend. The registration fee for multiple registrations is $475.00 per person. Registration for any one single day is $250.00 per person.
	Registration will be confirmed upon receipt of payment.
	Please retain a photocopy of this registration form for your records.
	Print and mail this form, with your check, to American Institute on Federal Taxation, Post Office Box 11248, Birmingham, Alabama 35202-1248, attention Carol Short.
	Please make checks payable to American Institute on Federal Taxation.
	If you need any assistance, feel free to contact the program coordinator, Carol Short, at 205-521-8175.
	CANCELLATION POLICY: The registration fee will be refunded if notice of cancellation is received prior to May 17, 2010, less a $25.00 administrative fee. Any partial registration is subject to cancellation in the event of capacity demand for full registrations.