Shipman & Butler Consulting, LLC

Shipman & Butler Consulting, LLC

2015 Seminar Registration Form

Please print & send form to: 520 West 21st Street #G2-229 Norfolk, Virginia 23517

OR e-mail to:

Phone: 757-409-7614 (voice) if you have ANY questions

For complete class schedule and details, please visit www.shipmanbutler.com!

Name: __________________________________________________________________________________________________________

Company Name & Address: __________________________________________________________________________________

__________________________________________________________________________________________________________________

Company Phone:___________________________________ Personal Phone: ________________________________________

E-Mail: __________________________________________________

Pre-Licensing Classes Continuing Education Classes

Please Check One: Please Check One:

___ August 13 & 14 - Chesapeake, VA ___ August 12 – Chesapeake, VA

___ October 22 & 23 - Fairfax, VA ___ October 21 –Fairfax, VA

___ December 10 & 11- Williamsburg, VA ___ December 9 - Williamsburg, VA

Cost: Participants ____ x $445.00 = ________ Cost: Participants ____ x $100.00 = _________

Please Mail Check to:

Shipman & Butler, LLC

520 West 21st Street #G2-229

Norfolk, Virginia 23517

E-MAIL NOTICE: This message contains information which is confidential and may also be privileged. It is for the exclusive use of the intended recipient(s). If you are not the intended recipient(s) please note that any form of distribution, copying or use of this communication or the information in it is strictly prohibited and may be unlawful. If you have received this communication in error please return to the sender. We would be grateful if you would also tell us on the Contact form then delete the email and destroy any copies of it. Thank you.

Disclaimer: Your information will be kept confidential and is for the sole use of the Shipman & Butler Company, LLC. It will not be distributed to third parties.