Name
Address
Town,
,    Zip
Telephone  EMail       
optional _____________________
  optional _____________________                            
SEMINAR PRE-REGISTRATION_________________________

Includes book issued to you on arrival

I/we will attend the Seminar on date ____________  at $35.00 each=$______

BOOK AND SEMINAR MAIL ORDER______________________
___ Book/s + Attendance Voucher/s   

    at $37.00 each=$ ______  

(includes postage & seminar admittance voucher)
 
I/we will attend the Seminar on date ___________________________ 

BOOK MAIL ORDER ONLY_____________

___ Books Only 

 

    at $22.00 each=$ ______  

(includes postage)
 
 
PAYMENT

Enclose check for $ _____  payable to SCORE Chapter 15.

 
Mail to:
SCORE Chapter 15
Attention: Walter Veit
Two Gateway Center – 15th Floor
Newark, NJ  07102