Course Signup Form
First Name:
Last Name:
Firm:
Address:
City:
State:
AL
AK
AZ
AR
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip Code:
Phone:
Fax:
Email address:
Are you insured by ALPS:
Yes
No
Check-in:
Session I 8:00 am - 8:30 am
Session II 1:00 pm - 1:30 pm
Session:
Session I 8:30 am - 11:45 am
Session II 1:30 pm - 4:45 pm
City
Date
Location
Session
Sign Up
Directions
Fairfax I
September 17
Waterford at Fair Oaks 12025 Lee Jackson Memorial Highway Phone: 703-352-3200
Morning
FULL
Fairfax II
September 17
Waterford at Fair Oaks 12025 Lee Jackson Memorial HighwayPhone: 703-352-3200
Afternoon
FULL
Manassas I
September 18
Four Points Sheraton 10800 Vandor Lane Phone: 703-335-0000
Morning
FULL
Manassas II
September 18
Four Points Sheraton 10800 Vandor Lane Phone: 703-335-0000
Afternoon
FULL
Waiting List
Salem I
September 24
Civic Center/James Taliaferro Complex 1001 Boulevard Phone: 540-375-3004
Morning
Salem II
September 24
Civic Center/James Taliaferro Complex 1001 Boulevard Phone: 540-375-3004
Afternoon
Waynesboro I
September 25
Best Western Waynesboro 109 Apple Tree Lane Phone: 540-942-1100
Morning
Waynesboro II
September 25
Best Western Waynesboro 109 Apple Tree Lane Phone: 540-942-1100
Afternoon
Richmond I
October 15
Koger Conference Center 1021 Koger Center Boulevard Phone: 804-379-3800
Morning
FULL
Richmond II
October 15
Koger Conference Center 1021 Koger Center Boulevard Phone: 804-379-3800
Afternoon
FULL
Waiting List
Williamsburg I
October 22
Marriott Williamsburg 50 Kingsmill Road Phone: 757-220-2500
Morning
Williamsburg II
October 22
Marriott Williamsburg 50 Kingsmill Road Phone: 757-220-2500
Afternoon
Virginia Beach I
October 23
Double Tree Virginia Beach 1900 Pavillion Drive Phone: 757-422-8900
Morning
FULL
Waiting List
Virginia Beach II
October 23
Double Tree Virginia Beach 1900 Pavillion Drive Phone: 757-422-8900
Afternoon
FULL
Waiting List
For more information:
call Jessica Walrath
at 800-990-3412 or e-mail her at
vamcle@alpsnet.com