AFP Program Registration

Full Name*

First NameLast Name
AFP Member?*

YesNo
Phone Number*

Area CodePhone Number
Company:
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Date of AFP Program*
Additional names and email addresses of those attending:
Do you have a dietary request for the meal?
Do you want to be invoiced?

YesNo
Please Click Here to return to our PayPal link for payment before submitting registration form.
If you wish to pay in advance via debit or credit card, please use the PayPal link below.
Complete and hit SUBMIT below. Your registration will be sent to AFPMASH after filling out the linked Pay with PayPal. Select "Pay with Debit or Credit Card" if you do not have a PayPal account.
prevnext( X )
AFP Member$10.00

Quantity

Non-Member$20.00

Quantity

Total $0.00
To send payment at this time:

Please make checks payable to:
AFP Mahoning-Shenango Chapter

Mail check to:
AFP Mahoning-Shenango Chapter
PO Box 672
Youngstown, OH 44501
Should be Empty: