Florida Tax Institute Registration

Registration:
Your Information: (Required fields in orange.)

Last Name:
First Name:
Nametag Name:	(i.e. Jim vs. James)
Company:
Professional Designations:
Address:
City:
State:
Zip Code:
Phone:
Email:

Event Attendance:	Full Conference, or: Wednesday Events Thursday Events Friday Events
Will you be attending the Wednesday evening welcome reception?
	Yes No
Will you be attending the Thursday evening welcome reception?
	Yes No
Are you a full-time professor?
	Yes No
Total Cost:
Credit Card Information:
Credit Card:	American Express MasterCard VISA
Card Number:
Exp. Date:	(mm/yy)
Name On Card:

Refund Policy:	Registrants will receive a refund less $75 administrative fee if a written cancellation notice is received on or before February 5, 2014.
	I have read and understand the continuing education credit and refund policies. In addition, I have read the continuing education credit page and understand which type(s) of credit are available.


	Please enter above security code:

Registration: