Mail to: David E. Miller 8207 Collier Place Tampa, FL 33637 CIM Version 3.4 813-985-4444 Date: ______________________________ Name: ______________________________ Address: ______________________________ ______________________________ ______________________________ ______________________________ Phone: ______________________________ Circle Registration Type Desired: Full Registration: $20.00 (provides support & updates) Registration: $10.00 Student Registration: $5.00 Contributer: $1.00