Registering Form For Upcoming Seminar Event

  BY SNAIL MAIL: Print out this form and follow directions. Mail the completed form and check/money order or Credit Card Information to the address below. Please fill out completely and recheck for any errors.

NAME__________________________________ Email_____________________________________________

ADDRESS ___________________________________  Postal CODE_________________ Date ____________  

TEL (_______)________-__________ Number of Participants______ Cost Per Person $________Total $_______

    

               November 02-20, 2007 - Bd$120.00/US$60.00 
               November 21-23, 2007 - Bd$140.00/US$70.00
               November 24, 2007
- Bd$150.00/US$75.00  (Day of Seminar Event)

Date of Seminar Event_________ Location_____________________________  Today's Date ________________

Credit Card Option      Type of Card:      Visa___ MasterCard___ American Express___ Discover___

Credit Card Number_______________________________________________    Expiration Date: ______/______  

Signature____________________________________

Name/address/phone info for Card: Same as above? Yes__ No__  If not, please place correct card info in space below

 

GRAND TOTAL (BDS) $________________/ (U.S. Funds) $______________

Send m/o to: The Freeman Institute, Box 305, Gambrills, Maryland 21054

Send personal/company check to: FreeMind Institute, Haynes Hill, Bank Hall, St. Michael

 Fax form (if using credit card) to: 246-426-7153 (secure fax)

Contact us if more information needed:

FreeMind Institute Inc: 246-426-1892
 Abundant Life: 246-427-9166
OR
Dr. Freeman: 410-729-4011     

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