Rugid enrollmentform2016b

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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 Company:

_______________________________________________

Attendee(s): _____________________________________________ _____________________________________________ Mailing address: ______________________________________________ City/State/Province: _____________________________________________________________

Postal Code: _____________________________________

E---mail: _____________________________________________

Phone: __________________

PAYMENT INFORMATION: $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 Master Card, Visa or AMEX

Expiration date: ____________

Card Number: ______________________________________ 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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