Enrollment form for "Protocol for Professionals"

Please print the form and register by mailing or faxing the completed form to the address below.

The Etiquette Class for Adults
       Seminars offered at ______________________ location.
       Date of Seminar:_______________________

Name (Mr., Ms., Mrs., or Miss) ______________________________________ Date______________
Position/Title ________________________________________________________
Company ____________________________________________________________
Address ________________________________________ E-mail _____________________
City, State, Zip ______________________________________________________________
Phone (work)_________________(home)__________________(cell)__________________
Dinner Preference (Circle One): Chicken or Vegetarian
Special Dietary Requirements: ___________________________________________
List skills you wish to gain from this seminar and your primary reason for enrolling:
_____________________________________________________________________
Where did you first hear about our school? _______________________________
(Please enclose a business card with enrollment form unless sending by fax.)

Requested Seminar Date:_____________________________

Investment $250.00 per person ($225 each for two or more)
Cost includes:

includes multi-course meal, dining tutorial,

workbook, award of completion, and instruction

Class Fee is due upon enrollment (Make checks payable to Academy of Etiquette & Protocol)

         ___ Enclosed is total investment in the amount of $__________
         Method of Payment (Circle One): * Check   Visa   Mastercard   American Express Discover
         Credit Card #_____________________________________ Expiration Date_________
         Name as it appears on the card:________________________ Charge Amount: ________
         Signature _________________________________________Date___________________

See Current Schedule for Upcoming Dates - (Private Consultations Available)
Reserve Your Space Now - Confirmation Mailed Prior to Class
Limited Space Available
Enrollment priority is based on the order in which form and fee is received.
*Cancellation must be made 72 hours prior to class time. Fee is non-refundable.