Issuu on Google+

2010 Collections & Bankruptcy School

2010 Bankruptcy School Orlando, Florida – October 13, 2010 Credit Union___________________________________________________________ Mailing Address:_______________________________________________________ Contact Name & Phone Number:__________________________________________ Registrant Name: __________________________________Title:_________________ Email Address:__________________________________________________________ Registrant Name: __________________________________Title:_________________ Email Address:__________________________________________________________ Payment Information: Bankruptcy School ONLY - $249/person CREDIT CARD AUTHORIZATION Credit Card Number

___ VISA

___ MasterCard Expiration Date

Cardholder’s Billing Address ____________________________________________________________ City/State/Zip

Print Name Authorized Signature CVV Number (three digit number found on back of card) Total = ___________

* Please return completed form to Becki Payne @ becki.payne@lscu.coop or fax # 205.991.2576


http://www.lscu.coop/content/download/21552/253649/2010%20Bankruptcy%20School%20-%20Registration%20F