MEMFFC Family Financial Workshop Registration Form

Workshop Register - STEP 1

Online Registration is a two part process:

STEP 1 Complete and submit this form.
STEP 2 Click the Paypal button and submit the appropriate amount*
*Be sure to remember the amount. We will check the
figures after payment.

Date of Seminar

	Select a Date
	June 3, 2007 July 21, 2007 August 18, 2007 Private Workshop (confirm date with Jeanne before paying)

Contact Information

Registration:

GROUP
Individual $250
Couple $375

PRIVATE
Individual $50 deposit
Couple $50 deposit

Name:

Email:

Paypal Email:

Only if different than Contact Email.

Street Address:

Street Address 2:

City:

State:

Zip:

Phone:

Fax:

(optional)

How did you hear about us?

Comments:

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