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Webinar Series
Webinar Series
optimaadmin
2023-05-08T22:06:09+00:00
Webinar Series
Name
(Required)
First
Last
Shop Name
(Required)
Billing Address
(Required)
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
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Maryland
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U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Email
(Required)
Phone
(Required)
How many people will be participating with your shop?
List additional attendees (up to 5)
Name
First
Last
Email
Name
First
Last
Email
Name
First
Last
Email
Name
First
Last
Email
Name
First
Last
Email
Webinar Ticket Price
$400:
for current members
$600:
for non members
Payment Options
(Required)
One time, Credit Card, 3.5% Fee
Check
ACH
For all credit card payments, the processing fee is included at checkout.
Membership Type
(Required)
Current AASP-IL Member | $400
Non AASP-IL Member | $600
Membership Type
(Required)
Current AASP-IL Member
Non-Member
Member Price
Price:
Non-Member Price
Price:
Bank Information
(Required)
Account Number
(Required)
Routing Number
(Required)
Accept
(Required)
I accept and authorize the ACH payments
By clicking [accept], you authorize AASP-IL to debit the bank account specified above for any amount owed for charges arising from your use of AASP-IL services and/or purchase of products from AASP-IL, pursuant to AASP-IL website and terms, until this authorization is revoked.
Important Steps
*ACH payment is initiated as you complete this form.
*AASP-IL will then set up a link to your account.
Check your bank account for a small deposit from AASP-IL.
*Verify this deposit and note the 6 digit code.
*Text the 6 digit code, along with your Business Name to Julie @ 630.561.3041.
*We will then confirm the payment.
This process may take a few days, depending on our mutual response times and the banks.
Complete online form & indicate check number & mailed date.
Please send to:
AASP -IL• 1005 W Huron St •Chicago IL •60642
Check Number
(Required)
Mail Date
(Required)
MM slash DD slash YYYY
Processing Fee
Price:
$0.00
Total
Credit Card
(Required)
Card Details
Cardholder Name
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