Please print out this form and mail in with your payment
NAME ___________________________________________
ADDRESS ________________________________________
CITY __________________________STATE, ZIP __________________
PHONE ___________________________________
E-Mail address _______________________________________
Enclosed is my payment for: Please CIRCLE what your payment is for.
Credit Card # (VISA/Master only)
______________________________
Expire date __________________
CVV number on back ______
Name on Card _______________________________________
Please CIRCLE which Seminar your payment is for.
SEMINAR #54A, January 19 - January 23, 2026
SEMINAR #54B, January 26 - January 30, 2026
SEMINAR #54C, Febuary 2 - Febuary 6, 2026
SEMINAR #55A, October 20 - October 24, 2026
SEMINAR #55B, October 27 - October 31, 2026
SEMINAR #56A, January 18 - January 22, 2027
SEMINAR #56B, January 25 - January 29, 2027
SEMINAR #56C, Febuary 1 - Febuary 5, 2027
Please CIRCLE which AMOUNT
your payment is for.
Deposit: $150.00
Balance $400.00
TOTAL $550.00
Please mail this to:
Mary Carole
7050 Lewis Lane
San Luis Obispo, CA 93401