REGISTRATION FORM BUDGET WORKS 2009

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					                                        REGISTRATION FORM
                                     BUDGET WORKS 2009
                                        FRIDAY, JANUARY 9, 2008
                                           8:30 AM to 3:30 PM
                                     COLORADO HISTORY MUSEUM
                                  1300 Broadway, Denver, Colorado 80203
                                              COST $35.00
Registration
Please submit registration and payment to the contact information listed below by JANUARY 7, 2008.

       Name(s):________________________________________________________________________

       Organization:_____________________________________________________________________

       Address:_________________________________________________________________________

       Phone:_______________________ Email:_____________________________________________

Payment
     $35 x _______=Total ______________________

          I would like to request a scholarship (Limited scholarships are available)
          My check is enclosed (Please make checks payable to: Colorado Center on Law and Policy)
          I would like to register now and pay at the door
          I would like to pay with a credit card

       Name on Card ____________________________________ Type ______________________
                                                                           VISA/MC/AE or DISCOVER ONLY
       Number_____________________________________ Expiration Date ___________
       CVV2#____ (Three-digit number on back of card)

       Billing Address if different from above _________________________________________________
    (AS SOON AS PAYMENT IS PROCESSED ALL CREDIT CARD INFORMATION WILL BE IMMEDIATELY DESTROYED)

                                  PLEASE RETURN THIS FORM TO:
             Scott Downes: via EMAIL at sdownes@cclponline.org or FAX at 303-573-4947
                   303-573-5669 ext. 306 | 789 Sherman St, #300 | Denver, CO 80203

If you need accommodations for a disability or need an interpreter if you speak a language other than English
 in order to participate in Budget Works (e.g. sign/language interpreting services, assistive listening devices,
 materials in alternate format), please indicate this need when submitting your RSVP along with your contact
           information. Requests for special accommodations are required by January 2, 2009.
  We will attempt to meet requests received after this date, but cannot guarantee availability of the requested
                accommodation. The meeting sites are accessible to individuals with disabilities.