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tcdla - Voice For The Defense Online

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Registration<br />

Greg Westfall<br />

John Ackerman<br />

Round Top Festival Institute<br />

January 9–13, 2013<br />

Contact Information | Reserve My Spot (limited number available)<br />

Onsite Registration Not Available<br />

❑ Criminal <strong>Defense</strong> Attorney $750.00*<br />

*Payment plans can be arranged—contact the TCDLA office.<br />

Name ___________________________________________ Bar Number ____________________________________<br />

Company ________________________________________Title/Position _____________________________________<br />

Street Address _____________________________________________________________________________________<br />

City _________________________________________ State __________________ Zip ______________________<br />

Email __________________________________ Phone ___________________ Fax _________________________<br />

**A questionnaire will be sent when registration form is received<br />

Payment (CASH IS NOT ACCEPTED)<br />

Payment type: ❑ Credit Card ❑ Check<br />

Total Payment: $____________________<br />

_______________________________________________ _________________________________________________<br />

Credit Card Number<br />

Expiration Date<br />

__________________________________________________________________<br />

Name on Card

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