Splinting Workshop, April 26, 2008

Registration Form:  NJOTA member:    YES       NO   (please circle)

Name________________________________________________________________________

Address________________________________________________________________________

City___________________________________________________________________________

State   __________         Zip Code_______________________________

Tel.#_________________________________________________________________

Payment by Check: made payable to NJOTA

$150  NJOTA members     &    $200. non-members

 Course Cost is based on minimum of 12 participants

Maximum number of participants is 24.

Please mail completed form and check to:

NJOTA

Felicia Chew

259 Ashton Drive,

Gibbstown NJ 08027

NJOTA and Orfit Industries America reserve the right to cancel course with fewer than 12 participants and will return all payments.

Cancellation policy: NJOTA reserves the right to cancel a workshop.  In the event of cancellation, NJOTA will offer a full refund within two weeks of notice of cancellation.  NJOTA is not responsible for reimbursement for any travel related expenses. Participants must also notify NJOTA regarding cancellation of registration no less than 14 days prior to the workshops for a full refund less $50.00 administrative fees