Office of Continuing Professional Education 10900 University Blvd. MS 4F2 Manassas, VA 20110 703-993-8335; Fax 703-993-8336; http://ocpe.gmu.edu SCHOOL OF POLICY, GOVERNMENT AND INTERNATIONAL AFFAIRS INTERNATIONAL SECURITY SUMMER PROGRAM 2015 *This information is required to maintain a permanent record of your non-credit activity in Mason’s student information system. If this information is not provided at the time of your registration the permanent record cannot be retroactively created. (Please print your Full Legal Name as it appears on your state issued ID card or passport) *  Mr.  Ms. First Please Check One Middle Last G Number (Mason ID #) * Previous Name (If used at Mason) First Middle Last Employer Job Title Work Address * Home Address City / State / Zip * City / State / Zip * Preferred Email * Preferred Mailing Address * Phone Home  Home Work Would you like to receive our monthly OCPE e-newsletter?  * Date of Birth  Yes Cell  No Arlington Campus –Founders Hall – 3351 Fairfax Drive, 22201 ST IS 0410 A01 21 Century Terrorism Monday-Wednesday  IS 0300 A01 Pandemics, Bioterrorism & International Security  Work Wednesday-Friday July 13-15, 2015 July 22-24, 2015 OTHER DISCOUNTS - Course Fee: $1195.00    Total $ - Discount $ Payment Total $ Alumni: $1095.00 Register more than one course: $1095.00 ea. Association (3 or more): $1095.00 ea. Method of Payment VISA _____ MasterCard _____ Check _______ Name on Card (Please Print): P.O. # _____ SF 182______ Cardholder Signature: (RequiredCardholder Address: (Required) Cardholder Phone: Credit Card Number: Expiration Date: Refund Policy: We recognize you may occasionally need to cancel your registration. You can substitute another individual in your place prior to your start. If you wish to receive a refund we must receive your request for cancellation no less than seven business days prior to the course start date. If you request a refund, a $60.00 processing fee is deducted. We are sorry that we cannot provide a refund if we receive your written cancellation in six or fewer business days before the start of the course. If you have requested a refund it may take several weeks to process. It is dependent on your method of payment. Checks may take up to six weeks since refunds are cut through the Commonwealth of Virginia. Payments will be refunded to the person/company that issued the original check to George Mason University. Processing of refunds to debit or credit cards will vary based on your financial institution.