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Mail-in Registration Form for Mission Control Seminar


Complete, print and mail all pages of this form with your check, money order or credit card number to JFVS, 2nd floor, 32 Ford Avenue, Milltown, NJ 08850.

Date of session

First name:

Last name:

e-mail address:

Day Phone:

Evening Phone:


Best way to reach you in an emergency: E-mail Day Phone Evening Phone

Date of Birth (MM/DD/YYYY):

Mailing Address:

City: State:

Zip code:

Company Name:

Title:


I am paying by:

check , money order, or credit card.

Amount paid with this form by check, money order or credit card (The fee is $629 per person; if six or more register as a group, the fee is $592 per person and all forms in the group must be submitted together):

If paying by credit card:

Credit Card Type:

Credit Card Number:

Expiration Month:

Expiration Year:


Please sign and date here before mailing:

Signature: ___________________________

Date: ___________

How did you hear about Mission Control? (Check all that apply):

Mission Control Representative:

Postal Mailing - card

E-mail

Web site

Friend

Colleague

Radio Announcement

Other


What other trainings and/or seminars have you taken? (Check all that apply):

Dale Carnegie training

Franklin Covey seminars

Landmark Education

Day-Timers

Business Works

Fred Pryor seminars

Other

Would you like a free subscription to the Mission Control newsletter?

Would you like to receive free additional information about Mission Control?

Name and e-mail address of any friend who is a previous graduate of Mission Control seminars

Shortly after you have registered, you will receive an e-mail confirmation letter with logistical information.

Cancellation:

While we intend to deliver every program, we sometimes must reschedule or cancel our programs. Mission Control reserves the right at any time to reschedule or cancel any program. In the event that Mission Control cancels a program, or reschedules a program to a date on which a participant is unable to attend, the participant will receive a full refund of tuition paid. Mission Control will not be responsible for any cancellation or penalty costs the participant may incur (including travel, hotel, etc.) or for any other loss or expense.

Registered participants in Mission Control programs may cancel their attendance at any time for any program. Mission Control will refund the total fee paid if Mission Control receives written notice of cancellation by email, fax or first class mail not less than 14 days prior to the start of the program. If written notice of cancellation is received less than 14 days prior to the start of the program, Mission Control will issue a refund of tuition paid less $100 for administrative and processing costs. All refunds will be issued within 10 days of receiving notice. For cancellation notices and questions about cancellations or refunds, please contact Mission Control at 1-888-793-8323 or email us at support@missioncontrol.com.

© 2008, Jewish Family and Vocational Service of Middlesex County