REGISTRATION FORM PAYMENT PLAN Please print fill out and mail or fax to enroll in classes Name____________________________________ Address__________________________________ Email Address______________________________ Phone Number_______________ Cell Phone_______________ Please Enroll me in the following classes (Specify Date to attend) Mandatory________________ City_____________ Elective _________________ City______________ BICAR __________________ City______________ Method of Payment check-Credit Card-Debit Card-or Cash We Accept Master Card Visa or Discover Credit or Debit Cards Visa MC Disc Specify credit or Debit Charge the Total Tuition to my card listed below Card No_________________________ 3 Digit card code_________ Exact Name on Card______________________________________ Expiration Date______________ By submitting this document to Dick Norwood Real Estate Seminars, I certify that I agree with the policies and Procedures of Dick Norwood Real Estate Seminrs. Card Billing Address_____________________________ Your Signature_________________________________
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