CPE SEMINAR Registration Form CONSUMER CREDIT COUNSELING MORTGAGE BROKER

							CPE SEMINAR Registration Form
CONSUMER CREDIT COUNSELING/
MORTGAGE BROKER & ORIGINATOR


      Do Credit Reports Scare You?
       Featuring Rod Griffin,
  Manager of Public Information
Experian
Date:           Tuesday, October 30, 2007
Time:           8:30 a.m. – 4:00 p.m.
Location:       Ndoki Lodge, Riverbanks Zoo,
                500 Wildlife Parkway, Columbia 29210

Area Hotels:         Embassy Suites 200 Stoneridge Drive, Columbia SC 803-252-8700
                     Residence Inn by Marriott 150 Stoneridge Drive, Columbia 803-779-7000


Submit a separate form for each enrollee AND       $30** non-refundable fee (**Continental Breakfast,
Lunch and breaks) per person. Make checks payable to SCDCA. Must be postmarked by
10/23/07.
Name:                    _______________________________________________________________
                            □ Credit Counselor  □ Mortgage Broker
Company Name
      _______________________________________________________________

Company Address          ________________________________________________________________

                         ________________________________________________________________

Company Phone #          ______________________         Email Address ___________________________

Driver’s License #       ________________________________ State of Issuance: ________________
                          (Include all numbers - do nor drop zeros)



                  YOU WILL RECEIVE 6 HOURS OF CPE FOR THIS SEMINAR

Inquiries:      Call 803-734-4209 or 803-734-4297
Mail to:        ATTN: Darlene Dinkins, SCDCA, P.O. Box 5757, Columbia SC 29250

 DO NOT FAX - REGISTRATION IS CONFIRMED WHEN FEE & FORM IS RECEIVED.
Seating is limited and is on a first come, first served basis. You must sign in between 8:30 a.m. – 8:55 a.m.
The class will begin promptly at 9:00 a.m. If you are more than 10 minutes late, you will not receive full credit.