Black Writers On Tour 2009 - Seminar Registration Form

BLACK WRITERS ON TOUR - 2009

Friday, May 1st - Sunday, May 3rd, 2009

Los Angeles Convention Center
1201 S. Figueroa St.
Los Angeles, CA 90015

Package #1
Regular Registration Only - $50
.

Package #2
**Early Registration Before April 5th, 2009**
Early Registration - $75
Regular Registration - $100

One Seminar

Pass for All Seminars

*Receive a $25.00 discount on packages 2 if paid by April 5th, 2009.

Register Early, Seating is Limited!

Please print this page, fill it out, and mail the completed form, with your payment
(checks made payable to Black Writers On Tour) to:
Black Writers On Tour
1425 W. Manchester Avenue, Suite C
Los Angeles, CA 90047

Name:

Which Package are you Purchasing?

Payment Amount:

Using your Credit Card and/or want to make an advanced payment using PayPal? Please include your Credit Card information below, or use the PayPal buttons.

Credit Card (please circle one):

Card Number:			Expiration Date:

Cardholder Name (Please Print):

Cardholder Signature:

Did you prepay using PayPal? If so, please provide your E-mail Address and the Transaction Id on your Pay Pal receipt:

BWOT Account Representative:			Date:

		Package #1 - $50.00
	Early Registration Before April 5th, 2009	Package #2 - $75.00
	Registration After April 5th, 2009	Package #2 - $100.00