Rogelio.net

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On-Site Registration Form

This form is only for On-Site CIMCE Activity Workshop.
Fill out form and submit, then send check or money order to:

Rogelio Camacho Seminars
617 Third Ave. #2
Chula Vista CA 91910

Name:
Court Interpreter ID. #:
Street Address:
City:
State:
Zip Code:
Home Telephone:
Work Telephone:
E-mail Address:
On-site Workshop of Interest::
On-site Workshop Date:
Amount to pay: