GLAZER-KENNEDY 2005 INFORMATION MARKETING SUMMIT
& BLUEPRINT SEMINAR ENROLLMENT FORM SPECIAL
NOTICE: Due to the nature of this Event, this enrollment form is
more complicated than usual. Please carefully check off all
areas that apply to you. You will receive a notification upon
receipt to confirm charges. At a later date you will receive
hotel information.
When: The SUMMIT: Nov 3-5;
BLUEPRINT SEMINAR: Nov 2
Where:
Dallas, Texas
CHECK OFF THE DAYS YOU WANT
TO ATTEND ALONG WITH YOUR MEMBERSHIP LEVEL
I WOULD LIKE TO PARTICIPATE FOR INFO-MARKETER OF THE YEAR AND WIN THE FREE TRIP and 1/2 DAY CONSULTATION WITH DAN, BILL & YANIK. (Note: You must submit your entry in order to qualify to submit)
*UPGRADE ME!
From
Gold to Gold+
From Silver to Gold
From Silver to Gold+
(Upgrade entitles you to the lower Registration Fee)
CLICK FOR MORE INFO
I AM A GOLD+ MEMBER AND WILL BE ATTENDING
THE FREE GOLD+ NETWORKING, HOTSEAT AND Q&A DAY WITH DAN AND BILL
SATURDAY, NOVEMBER 5th
ADDITIONAL REGISTRANT ATTENDING:
I want to register an additional
key person, partner or spouse to attend
for and additional fee of half my membership level fee above
Name
MY PAYMENT
PREFERENCE:
(*Deposit and/or installments paid NOT subject to refund.
Registration NOT subject to cancellation or transfer. Re-sale
strictly prohibited.)
*Member’s Name
*Business:
*Address
*City
*State
*Zip
*Country
*Phone:
*FAX:
*E-Mail:
MY PAYMENT
METHOD:
*Credit Card:
AMEX
VISA
MC
*Card # *Exp.
Signature:
________________________________________________
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