Seminar Registration (Workshop)

Mason-Dixon Concierge, LLC

Seminar Registration (Workshop)

Seminar Schedule

Registration Instructions

To register by mail print out and complete the registration form below, or request a registration form by calling customer service.

Make Checks Payable to: (Mason-Dixon Concierge, LLC)

Mailing Address:
Mason-Dixon Concierge, LLC
6400 Baltimore National Pike
#468
Baltimore, Maryland 21228

To register online please complete the online registration and payment form below.

Name:
Title:
Address
City:
State:
Zip Code:
Country:
Telephone Number:
Email Address:
Website:
Classes you plan to attend:	Monday $300.00 Tuesday $300.00 Wednesday $300.00 Thrusday $350.00 Friday $350.00 Monday and Tuesday $600.00 Tuesday and Wednesday $600.00 Wednesday and Thrusday $650.00 Thrusday and Friday $700.00 Monday thru Friday (5 days)$1,350.00
If you plan just to attend a few days and not a seminar week please list those dates below.
Seminar Dates: Time: 9:00am to 5:00pm (Please select which seminar week you plan to attend.)	May 5-9, 2008 May 12-16, 2008 May 19-23, 2008 June 2-6, 2008 June 9-13, 2008 June 16-20, 2008 June 23-27, 2008 July 14-18, 2008 July 21-25, 2008 August 4-8, 2008 August 11-15, 2008 August 18-22, 2008 August 25-29, 2008 September 8-12, 2008 September 15-19 September 22-26 October 6-10 October 20-24 October 27-31 November 17-21 December 1-5 December 8-12 December 15-19
Payment Information:	Check Echeck Cash Money Order Paypal Credit Card
Credit Card Type:	Visa MasterCard Discover American Express None
Credit Card Number:
CCV# (back of card):
Name (As it appears on Credit card):
Address where statment is received:
City:
State/Prov:
Zip:
Country
Authorized Electronic Signature:
Date:
Physical Needs: If you require special accommodations in order to attend this seminar please let us know what they are Below:	Yes No
Accommodations Requested:

Mason-Dixon Concierge, LLC
6400 Baltimore National Pike, # 468
Baltimore, Maryland, US 21228
customerservice@mason-dixonconcierge.com
Toll Free 1-(888)-747-9955 Local (410)-747-3009
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