(( Click here to go back to Seminar info page ))

Name _______________________________________

Address ________________________________________

City, state zip ___________________________________

Phone (h) _________________________ Phone (w) ________________________

Phone (c) _________________________ Phone (f) _________________________

Email (1) _________________________ Email (2) _________________________

Current Occupation ___________________________________________________

Past Occupations ______________________________________________________

Conventional education ________________________________________________

Real estate education __________________________________________________

Degrees/Certifications _________________________________________________

Mortgage Investment education _________________________________________

Investment experience _________________________________________________

Current investments - Properties ________________________________________

_____________________________________________________________________

Notes ________________________________________________________________

_____________________________________________________________________

Other investments _____________________________________________________