SCRIPT SECRETS CLASS

REGISTRATION FORM

Summer TBA 2012 - Location TBA

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:_________________

_____ $249 Early Registration (by ? 1)

_____ $349 Regular Registration (after ? 1)

_____ Returning Student (special rate)

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 2009 by William C. Martell