JSA All Instructor Symposium Payment Form

Please make payment as indicated below:

+ CREDIT CARD PRE-PAYMENT (anytime) please charge with a credit card using this link http://jsalis.org/purchase

+ CHECK OR CASH PAYMENT: please print this page and fill in the blanks, then mail a copy with your check or bring with your payment to the meeting. Please make check payable to “JSA of LIS, PO Box 212, Larchmont NY 10538.”

JSA Program Name:_________________________________________

*Attendees paid in advance _____ X ($40 pp for JSA organizations or $45 pp for non-JSA organizations = $__________ use credit card to get this rate for advance payment anytime, or mail check by June 17; see above)

*All Attendees paid later _____ X ($50 pp for all programs paid by check at door or mailed after June 17) = $__________

If you need to update your attendee count later, please email updates to info@jsalis.org.
Or, your prior responses may be edited if your IP address is recognized when you use the same computer to access the registration site.