+--------------+-----------------+-------------+---------------------+
| NARA Records |                 |             |                     |
| Management   |                 |             |                     |
| Training     |                 |             |                     |
| Payment      |                 |             |                     |
| Information  |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| E-mail reply | deborah.s       | Fax reply   | 781.663.0154        |
| form to:     | parrow@nara.gov | form to:    |                     |
+--------------+-----------------+-------------+---------------------+
| *            |                 |             |                     |
| *Information |                 |             |                     |
| for All      |                 |             |                     |
| Payment      |                 |             |                     |
| Methods**    |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Name of    |                 |             |                     |
| Trainee**    |                 |             |                     |
|              |                 |             |                     |
| \[same as    |                 |             |                     |
| Block 1, SF  |                 |             |                     |
| 182\]        |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Office     |                 |             |                     |
| Phone**      |                 |             |                     |
|              |                 |             |                     |
| \[same as    |                 |             |                     |
| Block 8, SF  |                 |             |                     |
| 182\]        |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Class      |                 |             |                     |
| Title**      |                 |             |                     |
|              |                 |             |                     |
| \[same as    |                 |             |                     |
| Block 16, SF |                 |             |                     |
| 182\]        |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Training   |                 |             |                     |
| Period**     |                 |             |                     |
|              |                 |             |                     |
| \[same as    |                 |             |                     |
| Block 18, SF |                 |             |                     |
| 182\]        |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Additional |                 |             |                     |
| Information  |                 |             |                     |
| for Credit   |                 |             |                     |
| Card         |                 |             |                     |
| Payment**    |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Name of    |                 |             |                     |
| Cardholder** |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Agency**   |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Street     |                 |             |                     |
| Address or   |                 |             |                     |
| PO**         |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **City,      |                 |             |                     |
| State, Zip   |                 |             |                     |
| Code**       |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| *            |                 |             |                     |
| *E****mail** |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **T**        |                 |             |                     |
| **elephone** |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **F****ax**  |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **           |                 | **Visa**    |                     |
| Mastercard** |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Card       |                 | *           |                     |
| Number**     |                 | *Expiration |                     |
|              |                 | Date**      |                     |
+--------------+-----------------+-------------+---------------------+
| **Amount to  |                 |             |                     |
| be Paid by   |                 |             |                     |
| Credit       |                 |             |                     |
| Card**       |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Additional |                 |             |                     |
| Information  |                 |             |                     |
| for Check    |                 |             |                     |
| Payment**    |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Make       |                 |             |                     |
| checks       |                 |             |                     |
| payable to   |                 |             |                     |
| the National |                 |             |                     |
| Archives and |                 |             |                     |
| Records      |                 |             |                     |
| Admi         |                 |             |                     |
| nistration** |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Send the   |                 |             |                     |
| check with a |                 |             |                     |
| copy of this |                 |             |                     |
| form to:**   |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Registrar  | Deborah Sparrow |             |                     |
| Name**       |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Room       | Northeast       |             |                     |
| Number**     | Region          |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Street     | 380 Trapelo Rd. |             |                     |
| Address**    |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Or         | National        |             |                     |
| ganization** | Archives and    |             |                     |
|              | Records         |             |                     |
|              | Administration  |             |                     |
+--------------+-----------------+-------------+---------------------+
| **City,      | Waltham         | MA          | 02452               |
| State, Zip   |                 |             |                     |
| Code**       |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Amount to  |                 |             |                     |
| be Paid by   |                 |             |                     |
| Check**      |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **Additional |                 |             |                     |
| Information  |                 |             |                     |
| for Purchase |                 |             |                     |
| Order and    |                 |             |                     |
| Training     |                 |             |                     |
| Form         |                 |             |                     |
| Payments**   |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| The          |                 |             |                     |
| following    |                 |             |                     |
| information  |                 |             |                     |
| **must** be  |                 |             |                     |
| provided if  |                 |             |                     |
| you wish to  |                 |             |                     |
| pay with a   |                 |             |                     |
| purchase     |                 |             |                     |
| order or     |                 |             |                     |
| training     |                 |             |                     |
| form.        |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **DUNS       |                 | **EIN       |                     |
| Number**     |                 | Number**    |                     |
|              |                 |             |                     |
| Dunn &       |                 | Tax         |                     |
| Bradstreet   |                 | Ide         |                     |
| Id           |                 | ntification |                     |
| entification |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **ALC        |                 | **PO/TF/Req |                     |
| Number**     |                 | \#**        |                     |
|              |                 |             |                     |
| Agency       |                 | \[Block     |                     |
| Location     |                 | 23\]        |                     |
| Code \[Block |                 |             |                     |
| 24\]         |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **BETC       |                 | **Amount to |                     |
| Number**     |                 | be Paid by  |                     |
|              |                 | PO/Training |                     |
| Training     |                 | Form**      |                     |
| Type Code    |                 |             |                     |
+--------------+-----------------+-------------+---------------------+
| **TAS**      |                 | **Funds     |                     |
|              |                 | Approver    |                     |
| Treasury     |                 | Name**      |                     |
| Account      |                 |             |                     |
| Symbol       |                 | \[Block     |                     |
|              |                 | 25\]        |                     |
+--------------+-----------------+-------------+---------------------+