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 $_______

     Early Bird Special: On or before February 15th, 2008 - TTD$320.00/US$50.00

  -TTD$380.00 / US$60.00 -- 16th Feb, 2008 until 22nd Nov, 2008- 12:00 midnight
-TTD$445.00 / US$70.00 -- 23rd Feb, 2008 until 29th Feb, 2008- 12:00 midnight

                             -TTD$475.00 / US$75.00 -- 1st, March, 2008 -- 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: WIST, 4th Bridge, Maracas, St. Joseph, Trinidad

 Fax form (if using credit card) to: 410-729-0353 (secure fax)

Contact us if more information needed:

 Marilyn Hamilton: 868-663-1501
OR
Dr. Freeman: 410-729-4011     

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