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 $_______

____ $20.00   -- EARLY BIRD SPECIAL...up to May 4th, 2008 - 12:00 midnight
____ $35.00 -- May 5th until May 16th, 2008 - 12:00 midnight
____ $50.00 -- May 17th, 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 $________________

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

Send personal/company check to: Freeman Institute, Box 305, Gambrills, MD 21054

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

Contact us if more information needed:

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