Please print the response form below and return the completed
response form and a check (payable to Jarsco Engineering Corp.)
or credit card payment to Jim Oliver, 18901 State Street, Corona,
CA 92881; phone/fax (951) 735-5239.
Registration Response Form
I am registering for the Motor Rewind Seminar. July 15-18,
2008
___ $1365 -Registration form and check payable to JARSCO Engineering
Corp.
___ $1365 -Registration form and Purchase Order to JARSCO Engineering
Corp.
___ $1365 -Registration form to JARSCO Engineering Corp. and
pay by credit card.
Method of Payment
___ Purchase order to JARSCO Engineering Corp
___ Check enclosed (payable to JARSCO Engineering Corp.)
___ Master Card ___VISA ___American Express
Cardholder's name _________________________________________
Card number ______________________________________________
Expiration date ____________________________________________
Signature of cardholder _____________________________________
Name of Attendee __________________________________________
Title/Department ___________________________________________
Organization ______________________________________________
Address __________________________________________________
City/State/Zip_____________________________________________
Phone __________________ FAX ____________________
E-mail Address _____________________________________________
Return card and your payment to:
JARSCO Engineering Corp., Jim Oliver, President, 118901 State Streete, Corona, CA 92881: phone/fax (951)735-5239.
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