THE CHICAGO SCHOOL FOR PIANO TECHNOLOGY

2041 W. CARROLL AVE. SUITES 227-229

CHICAGO, IL 60612

312/666-7440 or email chipianoschool@aol.com

SEMINAR REGISTRATION

ALTERNATIVE TEMPERAMENTS: TREVOR STEPHENSON, PHD

Seminar Date: August 7, 2010 1:30--5:00 PM

Name:__________________________________________

Address:________________________________________

                        _______________________________________

Telephone________________________________________

Email________________________________________

Seminar Cost: $55.00 (Advance Payment) $65.00 (After Aug. 6th or At the Door)   

Paying by: Cash___Check__Credit Card (Visa/MC only)___ If by Credit Card:

Card Name__________Card #_____________________Exp. Date_____

(NAME AND ADDRESS MUST MATCH CREDIT CARD BEING USED)

Signature____________________________________________________

Please mail this registration form to the address above with your check made out to The Chicago School for Piano Technology or with the appropriate credit card information.