Credit Card Form:

Programming with the Google Web Toolkit (GWT) 2.1

May 16-19 2011, Elkridge MD

The training course will run May 16-19 at the Johns Hopkins Dorsey Center in Elkridge, Maryland. The four-day course is taught by Yaakov Chaikin, costs $1995 per student, and includes an extensive course notebook, a commercial GWT textbook, breakfast, snacks, and lunch.

Please fill out the following, print it, and mail or fax it to the following address. Email registrations are permitted only for people paying at the door or using a purchase order; credit cards cannot be accepted by email due to credit card company regulations. However, you can preregister via email and pay with a credit card at the door. To do so, send name, payment info, and phone number to If you register for more than one course or send more than one student from the same organization, enter "Multiple" as the discount code and subtract $200 per person per course. Bonus: Register at least a week in advance and get a $50 gift certificate from, Inc.
    Attn: Course Registration
    6 Meadowsweet Ct, Suite B1
    Reisterstown, MD 21136-6020
    Voice: 410-429-5535, Fax: 410-429-4931


Student Name: ______________________
Name on Card (if different than student name): ______________________
Billing Address:
Phone: ______________________
Email: ______________________
Discount Code (leave blank if unknown): _________
Price ($1995 if no discount code): _________
Card Type (Visa, MasterCard, or AmEx): ____________
Card Number: ______________________
Expiration Date: ______________________
Signature: _________________________________