Fax: Send completed form (below) to me at 651-426-0983.

Mail: Send completed form to Jill Konrath, 2227 Foxtail Ct., White Bear Lake, MN 55110

Email: Send an email to mailto:jill@sellingtobigcompanies.com . Include all the info on the form below.

Remember, registering online right now is the only way to guarantee your spot, so dont delay!

_____________________________________________________________

JumpStart Your Sales in 2003 - Registration Form

Name: ______________________________________________________

Street Address: ____________________________________________

Apt/Suite: ________ City: _________________________________

State: _____ Zip: ______________ Fax: _____________________

Phone: _____________________________________________________

Email: _____________________________________________________

How did you learn about this workshop?

____________________________________________________________

I was referred by: _________________________________________

Payment Methods

____ Check ($139 enclosed) ____ VISA ____ AMES ____ Discover

Card Number: _______________________________________________

Expiration Date: ______/_______

Name on Card: ______________________________________________