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 _____________________________________________

____I cannot attend.  Please send me the manual for this program for $100.00 (add $4.00 shipping for the first set and $.50 for each additional set).  Please allow two weeks following the seminar date for delivery.  UPS will not deliver to a P.O. Box, so please include your street address.
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