Application
| MIDDLETON REAL ESTATE TRAINING, INC. 6-Hour Real Estate Continuing Education 1200, L5032, & L5034 Registration Form
Tuition Pre-Paid:
$55.00 -Tuition Walk-In $60.00 |
| PLEASE REMIT TO: New
Address and fax# as of January 16th, 2012
MIDDLETON REAL ESTATE TRAINING INC 2100 W. Big Beaver Suite 111 Troy, MI 48084 PHONE:(248) 355-3940
FAX: (248) 855-8435 |
| NAME |
| ADDRESS |
| CITY
STATE ZIP |
| HOME PHONE (
) WORK
PHONE ( )
|
| Email: |
| PERMANENT I.D.#650 |
| CLASS DATE |
| VISA/MASTER CARD |
| EXPIRATION DATE |
| Last four digits of Social Security # |
| SIGNATURE |
| $25.00 SERVICE FEE
FOR RETURNED CHECKS * MUST CANCEL PRIOR TO CLASS DATE FOR REFUND |