SEAK, Inc. Cape Cod, August 2003 REGISTRATION FORM

To register, call SEAK, Inc. at 508-457-1111, or Print this form and complete the requested information (neatly, please),
and FAX to SEAK, Inc. at 508-540-8304, with credit card information. 
Or mail with credit card information or check to:   SEAK, Inc. PO Box 729, Falmouth, MA 02541

priority code: Net

Please register me for:
___ Malpractice Survival Training For Physicians ($695) Cape Cod August 
       14-15, 2003
___How To Be A Successful Independent Medical Examiner ($695) Cape 
      Cod August 14-15, 2003
___Business School For Physicians ($695) Cape Cod August 14-15, 2003
___Asset Protection for Physicians ($395) Cape Cod August 16, 2003
___Non-Fiction Writing for Physicians ($795) Cape Cod August 16-17, 2003
___How to be an Effective Medical Witness ($695) Cape Cod August 16-17, 
      2003
___Leadership Skills for Physicians ($695) Cape Cod August 16-17, 2003
___Advanced Financial Strategies for Physicians ($395) Cape Cod August 17, 
      2003
___Negotiating Skills for Physicians ($695) Cape Cod August 18-19, 2003
___Law School for Physicians ($895) Cape Cod August 18-20, 2003

 

____Amount Enclosed  (Persons registering for two or more courses receive a 20% discount off of each course)

  Check Enclosed (made out to SEAK, Inc.)
  Credit Card Billing Type of card: ___Visa ___MC ___AE
Card No.

 

Exp. Date:
Signature

 

Please print or type all information. Use abbreviations as necessary.

Name                                                                                                                                                              Title
Name of Organization
Address

 
City                                                                           State                        Zip
Phone (Area Code/Number)                                       Fax
E-Mail
Specialty

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SEAK, Inc. FAX  (508) 540-8304