Application

MIDDLETON REAL ESTATE TRAINING, INC.

6-Hour Real Estate Continuing Education

Course 1800

  Tuition Pre-Paid:  $55.00 -Tuition Walk-In $60.00

PLEASE REMIT TO:                                                        

MIDDLETON REAL ESTATE TRAINING INC

901 Tower Dr. Suite 120

Troy, MI 48098

PHONE:(248) 885-8311   FAX:  (248) 885-8435

 

NAME

 

ADDRESS

 

CITY                                                                                        STATE                                           ZIP

 

HOME PHONE  (       )                                                         WORK PHONE (       )                                                       

Email:

 

PERMANENT I.D.#650

 

CLASS DATE

 

VISA/MASTER CARD

 

EXPIRATION DATE

Last four digits of Social Security #

 

SIGNATURE

$25.00 SERVICE FEE FOR RETURNED CHECKS * MUST CANCEL PRIOR TO CLASS DATE FOR REFUND

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