Registration Form
GMAT Test Prep Program
Stetson University Center
800 Celebration Avenue - Suite 104
Celebration, FL 34747
Phone: (321) 939-7604
Today’s Date: ____________________________
__________________________________ ____________________________ __________________
Participant Name (first, middle initial, last) E-Mail Address Phone & Extension
____________________________________________________________________________________
Participant’s Street Address City State Zip
Course Information
Course: GMAT Test Preparation Program
Dates: Tuesdays, February 9 through April 6, 2010 (8 weeks)
Times: 6 to 9 p.m.
Location: Stetson University Center at Celebration
How did you hear about
800 Celebration Avenue
Celebration, Florida 34747 this course?
Tuition: $495 (includes textbook)
From a mailing
Here's how to register for our GMAT Prep Course Program: From below news ad:
Use any of the following options below to send in your registration form: __________________
1. Fax: (321) 939-7639
From a Web site
2. E-mail registration form to: rcangelo@stetson.edu
From an associate
WorkForce
(scan registration form and attach via e-mail)
Other ____________
3. Mail registration form to: Stetson University Center
Attention: Ms. Rosemary Cangelosi ____________________
800 Celebration Avenue - Suite 104
Celebration, FL 34747
Method of Payment:
Payment amount: ______________
Check or Money Order (Make payable to Stetson University and send to Stetson University Center at the address above)
Credit Card: Indicate type: VISA MasterCard Discover American Express
Name on Card:___________________________________________________________________________
First Middle Last
Card Number: ___________ ___________ ___________ ___________ Expiration Date: _____________
Signature for credit card: _______________________________________ Security Code: ______________
(Security code may be phoned in if desired)