List Seminar Location(s):
Seminar:______________________________
Seminar:______________________________
____ Check here if paying for membership only.
Individual PAPA Membership Annual
Dues for calendar year:
____ 2006 (1/1/06-12/31/06) = $35
____ 2007 (1/1/07-12/31/07) = $40
____ 2008 (1/1/08-12/31/08) = $40
Total fees enclosed: $ ___________________
Registration Fees:
$200 = QAC Test Prep. Course - Early registration per
person, per location postmarked no later than 10 days prior to meeting.
$225 = QAC Test Prep. Course - Late registration per person, per location after early registation is closed.
Membership Fees:
$35 = per person per year for 2006 dues.
$40 = per person per year for 2007 dues
$40 = per person per year for 2008 dues
Who will be attending:
PCA, PILOT, QAL or QAC License #:
_____________________________________
Name:________________________________
Address:______________________________
_____________________________________
City: _________________________________
State: ______ Zip Code:__________________
Work Phone:___________________________
Cell Phone: __________________________
Fax Phone: ____________________________
Check or money order #:
_________________________________
Paid by:
_________________________________
