May 24, 2012, Independence, KS
325 N. Penn. Room 106, Ane Mae's (The International Mall)
The default $ value for each course is "35." If you choose NOT
to enroll in a course, select "0" for that course.
Each 4 hour class requires a payment of $35 per person.
The 1st class starts at 8am please be on time.
If you have enrolled in a course and can NOT attend; please give us a TWO day notice!
IF YOU DO NOT RECEIVE CONFIRMATION OF THIS REGISTRATION WITHIN 2 BUSINESS DAYS PLEASE CONTACT US AT (417) 624-5596.
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COURSE CITY: Independence, KS (05/24/2012)
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COURSE #1:
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COURSE #2:
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COURSE #7:
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TOTAL REGISTRATION FEES ($):
This $ value is also entered in the "Charge my Credit Card the Amount," below!
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Residential Information
All Information with an Asterisk (*) is REQUIRED
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*NAME:
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*STREET ADDRESS:
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*CITY:
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*TELEPHONE:
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*E-MAIL:
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*AGENT'S STATE:
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*LICENSE #
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ENTER ANY COMMENTS BELOW:
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You may pay by:
Credit Card (VISA, MasterCard, Discover or American Express) with this registration.
Cash or Check at the course site and before the lectures begin.
Check by mail to: Lowry School of Real Estate, 3636 Alpaca Rd, Joplin, MO 64804.
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Credit Card Information:
If the "Credit Card Number" as well as other vital information is blank,
we assume you will pay by cash or check.
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CHARGE MY CREDIT CARD
THE AMOUNT ($):
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CREDIT CARD NUMBER:
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TYPE of CARD:
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EXPIRATION YR:
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EXPIRATION MON:
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Invoice Information:
(if different from Residential Information)
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NAME (exactly as on credit card):
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STREET ADDRESS:
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CITY:
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