M&A Continuing Education & Training

General Info	Seminar Catalog	Registration Info	Registration Form	Instructors

		Registration Form

Complete the on-line registration form and submit or print. Boldface fields are required.

Name (Last, First MI)

Company Name

Mailing Address

City

State

ZIP

This is my

Daytime Phone, Extn.

Evening Phone, Extn.

Prof. License #
Specify Other:

Your E-mail Address

Please register me for the following classes:

1:

2:

Payment must be sent under separate cover and be received by Miraflor & Associates prior to the first day of the selected seminar(s). Please mail payment to:
Miraflor & Associates
1885 Savanna Way
Palm Springs, CA 92262

Fees may be paid by cashier's check or money order. Company and personal
checks will only be accepted for payment if received at least 10 business days in advance of the seminar.
Miraflor & Associates presently cannot accept credit cards or purchase orders for payment.
Returned checks are subject to a $20.00 NSF fee. Miraflor & Associates is not responsible for lost or delayed seminar payments.

I have read and agree with the above terms.

Please e-mail us with any questions or comments regarding our services. For comments or problems specific to this website, please contact the webmaster.