Seminar Registration Form

Please print and fax completed enrollment form along with payment information

to private and secure fax 909-623-0626

Registration form with payment due  prior to class selected

Contact / Credit Card Payment Information
Name	____________________________________________________
Address to mail confirmation include city/state/zip	____________________________________________________
Phone Number	____________________________________________________
Credit Card Number	____________________________________________
Credit Card Type	______ Visa      ______ Mastercard
Expiration Date   ____________________	CVC # (3 Digit on back)  __________________________________________
Authorized Signature *	_____________________________________________________

Select date/location to register for

Location: CITRUS VALLEY ASSOCIATION OF REALTORS 504 W. ROUTE 66 GLENDORA, CA 91740

_____ Notary Seminar/Workshop February 27, 2012                Seminar 8:00 AM-3:30 PM (Continental Breakfast & Lunch Inc) 3:30 PM (Notary State Exam)

 

 

 

 

 

 

 

 

 

 

 

 

*Upon signature you are authorizing Notary Masters to charge the above grand total amount to your credit card. 

Refunds or rescheduling on SIX-HOUR COURSE only if notified within 72 hrs. of requested date.

Check or Money Order Payment

Please make checks payable to: GEORGE SZALONEK Mail To:  NOTARY MASTERS     216 South Citrus Street #345 WEST COVINA, CA 91791