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Seminar Registration
Are you registering yourself, or are you completing this form for someone else?
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I am registering myself.
I am registering myself and others.
I am completing this form for someone else who will be attending.
Your First Name
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Your Last Name
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Best Phone Number
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Your Email Address
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Please list the city where you wish to attend the seminar:
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Attendee Information
First Name
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Last Name
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School Name:
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Street Address
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Address Line 2
City
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State
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Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Washington DC
Zip Code
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Work Phone Number
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Cell Phone Number
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Email Address
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Please email me updates about this event
Fax Number
Is this registration just for one person or a group?
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Just this one person
A group
Please enter the names of the other people in the group?
Payment Information
How will you be paying for the seminar registration?
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Credit Card
Purchase Order
Check
A representative from our office will contact you to take your credit card number over the phone. You will be contacted at the phone number you entered above.
Please fax your Purchase Order to: 419-735-0291.
Purchase Orders should be made out to:
Ideas Unlimited Seminars, Inc.
P.O. Box 272
Slinger, WI 53086
309-662-5016
Please mail your check to:
Ideas Unlimited Seminars, Inc.
P.O. Box 272
Slinger, WI 53086
309-662-5016
Please click "Submit" below to complete your registration.
Please print the confirmation page to confirm your registration.
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