Workshop Registration Form

Registration Fee: $259.00 (plus applicable taxes) for the first participant, and $200.00 for each additional participant. Spouses are invited at no additional cost.

Registration includes:

• Continental Breakfast
• Lunch
• Personal copy of our 355 page workbook

Security

This site has security measures in place to protect the loss, misuse, and alteration of the information under our control. (When credit card or banking information is collected, it is on the secure server only.)

My Spouse at no additional charge My Business Partner will also attend for an additional $200.00 each. Workshop runs from 8:30 a.m. until 3:30 p.m. Please advise us of any dietary concerns.
Workshop Location:	Select a Workshop Baltimore, MD London, ON Los Angeles, CA Oakville, ON Oshawa, ON Philadelphia, PA Portland, OR San Francisco, CA Seattle, WA St. Catharines, ON Stoney Creek, ON Toronto, ON Wilmington, DE
Company Name:
Name of Attendee:
Title (eg. President, CEO, etc.):
Address1:
Address2:
Name of Guest:
Title (eg. President, CEO, etc.):
Phone Number:
Fax Number:
*Email Address:
Web site url: http://
Do you wish to have confirmation:	Faxed   Mailed   Emailed
Method of Payment:	Credit Card Type of card: Visa MasterCard Name on card: Card # Expiry Date: / Cheque (to be received in advance)
Type of Business:
Date Started:
Number of Employees:
Approximate Gross Annual Sales:
*= required Security This site has security measures in place to protect the loss, misuse, and alteration of the information under our control. (When credit card or banking information is collected, it is on the secure server only.)