SCRIPT SECRETS CLASS

REGISTRATION FORM

March 4th & 5th 2005 - Grand Hotel, Minneapolis

You can print and mail this form to me, or send the information in an e-mail.

NAME: ___________________________________________________

Street Address:____________________________________________

City:_________________________ State:_______ Zip:_________

E-mail:__________________________________________________

Home Phone: __________________Work Phone:_________________

_____ $149 Early Registration (by January 31)

_____ $199 Regular Registration (after January 31)

I found out about this seminar from: _________________________

I was referred by: ___________________________________________

I have referred: _________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________

Send the registration form and Check or Money Order to:

William C. Martell
11012 Ventura Blvd PMB 103
Studio City, CA 91604-3546

Want to pay by credit card? Click on Payment Methods below...

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copyright 2004 by William C. Martell