Rugid enrollmentform2016

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Enrollment and Payment Form Master Rug Cleaner Advanced Rug ID Boot Camp January 29-30, 2016

Do you already own a copy of A Comprehensive Guide to Oriental & Specialty Rug Cleaning? ❏ Yes ❏ No Name/Company:_______________________________________________ Mailing address: _____________________________________________ City: ________________________________________________________ State/Province/Postal Code: _____________________________________ E-­‐mail: _____________________________ Phone: __________________ PAYMENT INFORMATION: Due December 1, 2015 $995 first attendee; $795 second attendee, same company ❏ Payment in full by check payable to: Master Rug Cleaner c/o Oriental Rug Cleaning Co. 3907 Ross Avenue Dallas, TX 75204 ❏ Full Payment by credit card ❏ $200 deposit by credit card and $200/month until balance paid Master Card, Visa or AMEX

Expiration date: _______________

Card Number: _________________________________V-­‐Code________ Name on Card: _______________________________________________ Credit card billing address (if different from mailing) ____________________________________________________________ Total Tuition: ______________ Date: _____________ Signature ________________________________ Master Rug Cleaner - 3907 Ross Ave. Dallas, TX 75204 - Fax 214/821-9136 - ellen@masterrugcleaner.net


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