SEMINAR - FAX / MAIL REGISTRATION FORM 
Print this form and fax it to 949-388-8564

Name: _________________________________________

Title: __________________________________________

Company: ______________________________________

Address: _______________________________________

_______________________________________

City: ______________________State: _____Zip: _______

Telephone: (____) ____ - ________

Fax: (____) ____-________

Email: ______________________________

Seminar:___________________________________ 

Date:_________ Location:____________________

Payment: VISA__ MasterCard __ Check enclosed__

Card#________________________________

Name on card: _____________________ Exp. Date: _____/_____

Signature__________________________

Seminar fee: $1,395/particpant - 3 or more participants from the same company qualify for reduced rate of $1,295 each.

Phone orders: (800) 8-LAGUNA. Have your credit card ready.

Mail orders: Laguna Group, Inc. 30251 Golden Lantern #108, Laguna Niguel, CA 92677