Use this form to register for the Seminar, and indicate your preferred date and time. Each Seminar will be held in Portland, Oregon at a location to be determined. Once the location of the Seminar is confirmed based on the number of attendees, you will receive an email with details on the location and time. Each seminar is expected to last one hour. You may pay at the time of the Seminar.

Name

First Name

Last Name

Email Address

Re-enter Email Address

Phone

(###)

###

####

Please indicate the Seminar Date you prefer:

Seminar Date Requested

Inform me of other dates in the future

December 11 at 7:00 p.m.

Message

Please describe any special accommodations you require and whether you are interested to learn about a particular aspect of the Executive Action

I confirm that I will be prepared to pay the following Seminar Fee at the time of the seminar by cash, check or credit card

Seminar Fee