NAME:________________________________________________________
SEMINAR: SBA & Alternative Financing
DATE:_________________________________________________________
TOTAL DUE: $69.00
NOTES: Fee includes registration, CD, info sheets, financing a business.
PAYMENT: Please make checks payable to Russell W. Rodgers,
Business Doctor
You may also pay by credit card (check one):

_____MasterCard, _____VISA or _____American Express.

________________________________________________________________
Credit Card Number and Expiration Date
________________________________________________________________
Amount
________________________________________________________________
Cardholder Name
________________________________________________________________
Cardholder's Signature
_________________________________________________________________
Billing Address
_________________________________________________________________
Billing Zip or Postal Code

_________________________________________________________________
Email Address

FAX TO: (810) 213-0244
Please tell us about yourself so we can tailor the seminar to your needs. Thank you!
__________________________________________________________________
__________________________________________________________________
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Russell W. Rodgers
The Business Doctor

www.businessdoctor.info
Phone (727) 639-4398
Skype # Marine19565431
rrodgers@veriozn.net