Registration Form For Rehabbing Houses Workshop Registration Form

Name: ________________________________________
Partners Name: ______________________________________________
Company Name: ______________________________________________
Shipping Address: ______________________________________________
City, State, Zip: ______________________________________________

Email (please printed clearly): ______________________________________________
Daytime Phone: _______________
Evening Phone__________________

Check The Card You Are Using… Visa / MC / AMEX / Disc
______________________________________________
Expiration Date: __________
Name On Card: __________________________

Signature _______________________________________

Pricing for the Rehabbing Workshop Pick What You Want…

__ Check here $697 For 1 person 2 Day Workshop
__ Check here $997 for 2 people for the 2 day workshop
__ Check here $297 Repeat Workshop… Per Person
__ Check here $100 Child Interested in Investing Age 18 - 21
Your Total Workshop Cost ___________________

Fax this form to: 317-405-9152 are Call Dwayne 317-987-6321
Check here if you would like to make partial payments and we call you. _____

Are you can Email us at Rehabbinghouseswork@yahoo.com