If you wish, in most browsers this form can be filled out online and then printed.

TO:          Business Growth Centre

Fax No.    61 3 9803 5755
Yes! I want to be part of the TeleSeminar on Wednesday 13 May 2009
"How to be a Confident Speaker!"
Please Register:
     
Number of Registrant/s: @ A$75 ea
Title:
First Name:
Last Name:
Company:

About My Business:
(Please indicate the nature of your business to assist Winston in tailoring his presentation to your needs)

Position:
Address line 1:
Address line 2:
Suburb/Town:
State:
Post Code:
Country:
Phone:
Fax:
E-mail:
Payment Details:
Credit Card Type:
Card Number:
Expiry Date:  
Cardholder Name:
Signature:
Print this form and fax to 613 9887 5581
Please note: Bookings will be heavy.
Please register as soon as possible to guarantee your place!
Business Growth Centre, 903 High Street Road, Glen Waverley, Vic, 3150, Australia