Participant(s) Information:

Name: 

Title:

Organization: 

Address:   

City:        State:      Zip Code:  

Phone:     Fax:

Email: 

Additional Name(s):

Current course(s) for which you are registering:

General Nonprofit Programs

Establishing A Nonprofit Organization (Apr. 13, 2010) - ($45)

Effective Nonprofit Management: A Situational Approach to Supervision  (Apr. 30, 2010) - ($195 for one, and $175 for each additional agency rep)

FUND RAISING CERTIFICATE program

Winter/Spring 2010 Semester

Payment Information (check payment method):

Check enclosed, payable to UMKC

Credit Card Charge (Visa, MasterCard, Discover)

              (These are the only credit cards we accept)

Payment Amount:

Credit Card Information:

Cardholder Name:

Card Number:

Expiration Date:

Cardholder Signature: _____________________________