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Code of Ethics

Registration Form
Please print this form, fill it out and send with your check or money order to:
MSI
2135 Ashland Ave Suite 3 Evanston IL 60201


Date of Class:

Oct 23 Sunday

Time of Class:

12:00 - 6:00pm

Location:

MSI Classroom Great Hall of Learning
2153 Ashland Ave. Evanston IL. 60201

Name
 
Address
 
City, State & Zip
 
Telephone
 
Email address
 
Correct name for certificate
 
Total Amount Submitted
$
Check or
Money Order #
 

Class Fee $145.00 .A non-refundable deposit of $50.00 is required to hold your seat.
All students must be registered and paid in full by Oct 23 2011.
There is a limited amount of seating and classes fill up quickly so please mail this form in
with your deposit. You will receive a confirmation call following the receipt of your registration.
Visa/MC/American Express/Discover accepted.

Office use only
Date Rec'd initials of staff member
recording info
Date Data entry complete Date confirmation call date Filed/assigned
books & material