American Institute on Federal Taxation 2011
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 luncheon on Thursday, June 16: ______  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 16, 2011, less a $30.00 administrative fee.  Any partial registration is subject to cancellation in the event of capacity demand for full registrations.