Registration Form

    Name: ___________________________________________________________

    Address: __________________________________________________________

    City: ______________________ State:______________ Zip Code:___________

    Phone Number: _________________________ Email:_____________________

Seminar Dates Attending: ______________________

    Double ____ ($960.00)  Single ____ ($567.00)

Check Enclosed: _____  Visa: _____  MasterCard: _____

    Name On Credit Card: ______________________________________________

    Credit Card Number: _______________________________________________

    Expiration Date: _______________  3 Digit Security Code: ________________

A confirmation and information letter will be mailed to you.

There is a 30 Day Cancellation Policy.  To receive a full refund you must notify us by phone (888.298.8855) or email (jhuntington@seidata.com).  However a 10% service fee will be deducted.

Thank You!

Philip & John, The Huntington Bed & Breakfast

&

Ed & Karen, The Newman-Vollmar House