Print this form....fill it in and mail with your payment :

Advanced CPTED Certification  Seminar

 

_____    May 21-23, 2007 - Louisville, KY

_____    November 5-7, 2007 - Louisville, KY

$415.00 each or $360.00 if more than one participant from the same department. 

Name:________________________________________

Position/Title:________________________________________

Department:________________________________________

Institution:________________________________________

Address:________________________________________

City:_________________________     State:_____   Zip:__________

Telephone: (____) _______________

FAX: (_____) _______________

_____Check Enclosed _____P.O. Enclosed _____Bill Me

Credit Card Number ___________________________  Exp. Date ___________
(American Express, Discover, Visa or MasterCard)

Mail To:
The AEGIS Protection Group
American Crime Prevention Institute
327 Townepark Circle
Louisville, KY 40243
U.S.A.

Telephone: (502) 244-7306
FAX: (502) 244-7308

Make Checks Payable To: AEGIS Protection Group, Inc.