FAX & MAIL REGISTRATION FORM |
Please Mail or Fax this form to |
Fax to: (614) 449-8136 |
Mail to: CLE Inc. P.O. Box 16005 Columbus Ohio 43216 |
Does this Confirm a Phone or Fax registration? Yes ___ No ___
Seminar Title and Date ________________________________________________________
Name _____________________________________________________________________
Address ___________________________________________________________________
___________________________________City ____________________________________
State _______________ Zip ___________Phone (_____)_____________________________
Fax (_____)_____________________________
E-Mail Address ______________________________________________________________
Please choose one of the following payment options
Check enclosed payable to CLE Inc.____
MasterCard____
Visa____
Card No. ___________________________________________________________________
Expiration Date __________________________
Signature _____________________________________________
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