Registration

Benefits Training and Consulting

P.O. Box 40, Oxford, PA 19363

Telephone: (610) 696-1551 Fax: (610) 932-0428 E-mail: wallinginc@aol.com

Workshop registration

Registration fee:

$109.00 per person for - Employment and Benefits in 2008 - Medicaid, Medicare,

Social Security, and SSI

$109.00 per person for - Beyond the Basics of Social Security, SSI,

Medicaid, and Medicare.

Register three people for a workshop and the fourth person is free.

The registrants can attend different workshops. Be sure to indicate

which location each person is attending.

Payment can be made by card card, check, or cash. If you register online and do not use the option to pay by credit card, you can send your payment to Benefits Training and Consulting, or pay at the workshop. The important thing is to register to reserve a seat.

Also, we do accept Purchase Orders, just click the box before "Please invoice our agency" and provide the PO number.

Special offer with registration

$45.00 for a set of publication. Includes (1) "The Guide", (1) "Managing Your SSI Benefit and Income Handbook",

and (1) "Managing Your SSDI Benefit and Income Handbook." (Save $47.00 off regular price) The offer is only available

to individuals attending a workshop. The publications are not needed to attend the workshop, a training packet is supplied at the workshop.

Workshop Date:

Workshop Location:

Register up to four people - fourth person is free.

First Name: Title:

Second Name: Title:

Third Name: Title:

Fourth Name: Title:

Organization:

Street Address:

City: State: Zip Code:

Telephone: (include area code & number)

Fax: (include area code & number)

E-mail Address:

Set of Publications Special: Number of sets at $45.00 per set

Method of Payment

Credit Card Payment: Visa Mastercard American Express

Card Number: Expiration Date: (mm/yy)

Please invoice our organization. Purchase order #

If you are paying by check, payment can be sent after registration form is submitted or

you can bring the payment to the workshop.

If you wish to register by mail or by fax - block and print this page.

Mail Order To: Benefits Training and Consulting

P.O. Box 40, Oxford, PA 19363

Fax Order To: (610) 932-0428

Make check payable to Benefits Training and Consulting

Fee includes handouts and refreshments. All registrations will be confirmed.

Payment can be sent after you register by e-mail or fax, or you can bring the payment to

the workshop.

Unless noted otherwise - registration begins at 8:30, the presentation begins at 9:00, and the

workshop concludes by 4:00 PM. Lunch is on-your-own.

(1) Cancellation received, in written or faxed form, before the workshop is refundable or may be applied to a future

workshop. Please note: if you do not cancel and do not attend, you are still responsible for payment. Substitutions may

be made at any time. (2) Benefits Training and Consulting reserves the right to cancel any workshop and refund

registration fees due to insufficient enrollment. We are not responsible for travel, lodging, etc. if a workshop is

canceled.

The Social Security Protection Act, P.L.108-203, signed by President Bush on March 2, 2004

requires us to inform you that the Social Security Administration offers free presentations on

Social Security and SSI benefits. You must contact your local SSA office for information

regarding the availability of such presentations.

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