Name 1:            

Name 2:        

Name 3:        

Name 4:            

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Agency:            

Address:            

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Please Select One Check American Express Visa Master Card                Check #    
 

IF PAYING BY CHECK PLEASE MAIL TO:
MEDICARE TRAINING & CONSULTING
1905 BERNICE ROAD Ste. 7
LANSING IL, 60438

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Attending:    Please Select One Western Mediterranean Cruise, June 14-21, 2009 Maui, Hawaii - July 22-25, 2009

   Cancellation Policy 
If Medicare Training & Consulting must cancel a seminar due to low registration a refund will be issued. If a participant cancels 15 or more calendar days prior to the meeting date, a refund will be issued. After 15 days you will receive a credit which may be used to enroll in a future course. We are unable to grant refunds for lodging, air fare, administrative fees, etc.