Meeting Registration Form

TBRUG now accepts American Express!!!

Application for membership to TBRUG:

Company:
Address:

City:	State:	Zip:
Phone:

Name:
Title:
EMail:

Name:
Title:
EMail:

The sum of $_____ is enclosed, payable by check or money order (no cash) to: TBRUG, for ____ individual membership(s). Corporate memberships are not available.
Cost of membership is $10 per person, and are a one time lifetime fee, and are non-transferable.

Meeting Registration Form:

Tampa Bay Relational User Group Cancellation/Refund Policy

TBRUG must provide our caterer a head count by the Monday before the meeting, which means that we are obligated to pay for those meals. Due to this cost, the information below details TBRUG’s cancellation/refund policy:

A refund/returned check will be allowed if a Board member is notified in writing (email) by NOON on the Monday prior to the seminar. Note: TBRUG seminars are always held on Friday - the cancellation notice must be received by Monday at noon of the same week.

Refunds/returned checks will be sent back to the member’s address on file.
If a cancellation notice is received after noon on the preceding Monday, the funds will be forfeited.

Name:	Member:	Yes / No
Name:	Member:	Yes / No
Name:	Member:	Yes / No
Name:	Member:	Yes / No
Company:	Phone:
Amount Enclosed:

Method of payment (Please check one):
____ Check (Made payable to: TBRUG)
____ Money Order (Made payable to: TBRUG)
____ American Express (Fill out the following information)

Card Number __________________________________ Exp. Date: ___________
Phone Number _____________________________________________________
Name as it appears on card: ___________________________________________
Authorized Signature: ________________________________________________

Mail to:

TBRUG
PO Box 3424
Clearwater, FL 33767