Registration Form

Course: ASA Designation

September 14 & 15, 2010 --- Time: 9:00am to 5:00pm both days
Continental breakfast served from 8:15am Lunch around 12:15pm

Course Location: Keller Williams Real Estate Associates Brokerage

7145 West Credit Ave, Bldg 1, Suite 100
Mississauga, ON L5N 6J7 - (Hwy. 401 & Mississauga Road)

ASA EXAM YES NO (Check here if you only want credits and no designation)

Name:

RECO License Number (Required): Company:

Address:

City: Province: Postal Code:

Telephone: Fax: e-mail: ______________

Total cost: $395 + $51.35 HST = $446.35 Visa MasterCard Cheque

Must be received before
course start date

Cardholder’s Name: Card #:

Expiry Date: / Signature:

Please Print Clearly

Please fax back to 416-781-3333
Outside Toronto fax back to 1-866-406-4978

If paying by Cheque Make Cheque payable to: The Real Estate Academy Inc.
Mail to: 991 Roselawn Avenue,Toronto, Ontario M6B 4M9

For more information call 416-784-9806 or 1-877-446-3999

Please note registrations are processed only with receipt of payment.

A 15% administration fee is applicable for refunds on all registrations. Sorry, no refunds 24 hours before seminar.