Contact Information:
Kathy Lindeman
1604 East Yampa St.
Colorado Springs, CO
80909
(719) 473-6634
Send an e-mail
Kathy Lindeman
1604 East Yampa St.
Colorado Springs, CO
80909
(719) 473-6634
Send an e-mail
Secure Registration Form
Click here if you would prefer to print a hard-copy of this form and mail your application to us.
To register for the 2018 Antiquarian Seminar, please complete the secure registration form below.
When you have completed all sections, click the "Continue" button at the bottom of the form. You will be asked to confirm your information on the next screen.
Mailing Information
| Title: | *First Name: | *Last Name: |
|---|---|---|
| Company/Business/Library (optional): |
|---|
| *Your mailing address (where you want to receive course materials): |
| *City/Town: | *State/Province: | *Zip/Postal Code: |
|---|---|---|
| *Country: |
|---|
| *Daytime Phone: | Alt. / Evening Phone: | Fax: |
|---|---|---|
| *E-mail: | ||
|---|---|---|
| Is there any alternate contact information you may wish to provide us?: | ||
| Years in Profession (if applicable): | ||
| Specialties/Subjects/Fields (if applicable): | ||
| *How did you hear about the seminar?: | |
|---|---|
Billing Information
| Please enter your billing information below. |
| Title: | *First Name: | *Last Name: |
|---|---|---|
| Company: |
|---|
| *Your billing address: |
| *City/Company: | *State/Province: | *Zip/Postal Code: |
|---|---|---|
| *Country: |
|---|
Payment Information
| We accept: |
|
|---|---|
| Payment Amount: | ||
|---|---|---|
| Payment Method: | ||