American Society of Appraisers - Course Registration

Registration Form

Please print this form and send completed form with payment to:

Education Registrar
American Society of Appraisers
555 Herndon Parkway, Suite 125
Herndon, VA 20170

Please wait for your confirmation registration letter before making nonrefundable travel arrangements.

Course Information

Course #:

Course Title:

Course Date:

Location:

Personal Data

Membership #:

ASA Membership Status:

ASA AM Candidate Associate
Membership Pending Nonmember*

What is your Appraisal Discipline?

Appraisal Review & Management
Business Valuation
Gems and Jewelry
Machinery and Equipment
Personal Property
Real Property

Mr.	Ms.	Mrs.	Dr.
Ing.	Hon.	Rev.	Capt.

First Name:

Middle Initial:

Last Name:

Company:

Address:

City:

State/Province:

Country:

Zip/Postal Code:

Is this an address change? Yes No

Phone:

Fax:

E-mail Address:

Education/Degree(s)

BV Registrants:
Do you intend to pursue the ASA designation? Yes No

What is the highest level ASA course previously passed (check one if applicable)
Level 201 Level 202 Level 203 Level 204

Are you auditing this course?
Yes No (If auditing, no exam will be provided during testing session.)

How did you hear about this course?
Brochure
ASA Web site
Other

Please indicate any special needs:

Course and Payment Information

Method of Payment

Check	Government purchase order enclosed
(payable to American Society of Appraisers)

VISA

MasterCard

American Express

Card Number:		Exp. Date:

Signature:____________________________________

Payment in full must accompany this form.
Please Note - If registering for a course within 30 days of the course date, please add a $50 late registration fee.
* If you are not a member of ASA but are a member of a society that is an appraisal sponsor of the Appraisal Foundation (ASFMRA, AI, AI, AIC, IAAO, IRWA, NAIFA, NAMA) or are a member of the NAR appraisal section, you're eligible to attend ASA course in any discipline at the member tuition rate. Please submit proof of current membership along with this registration form.