REGISTER ONLINE BY COMPLETING THE FORM BELOW OR REGISTER BY MAIL OR FAX.
(click for printable pdf)

 

BOOT CAMP REGISTRATION IS CURRENTLY CLOSED

Be Placed On The Waiting List
We have reached the maximum number of attendees and will only be accepting mailed registrations from those holding scholarship certificates.

Scholarship certificate holders who need a registration form -- or those who would like to be placed on a Waiting List should call Sales Creators.

Call (818) 597-3205

We will need your
Name, Phone number, E-mail address

Thank you for your interest in this conference.
Check out the National LTCi Producers Summit
October 16-18, 2005
Westin Crown Center, Kansas City


 I wish to register for the
Multi-Life LTCi Boot Camp
May 1-3, 2005 in Kansas City

 

Registration Fee
$279 (through April 4, 2005)
$379 (April 5, or after)

If you received a discount code enter here:

Discount Offer
Check box to subscribe to:
LTCi Sales Strategies Magazine
only $24 per year. We will deduct $50 from your registration fee.

First Name: Middle Initial: Last Name:

Title:

Name on Badge (First or Nickname):

Company / Agency Name:

Address:

City: State: Zip Code:

Phone:  Email:
* E-mail Privacy Notice: Sales Creators, Inc., does not sell or share E-mail addresses. We use this information to communicate with attendees.

Pay by Credit Card:
Cancellation Policy:  If you must cancel for any reason, notify us in writing via trackable FedEx prior to April 22, 2005 to receive a refund less a $100 cancellation/processing fee.  NO refunds will be given for cancellations received after 5 PM Pacific Time April 22, 2005.

Visa     MasterCard     AmEx

Name on Card:

Card Number:   Expiration Date:

Billing Address:

City: State:   Zip Code:

Security Code:
Enter last 3 digits of security code from back of credit card

By completing the information above and submitting you are authorizing Sales Creators, Inc. to charge your credit card.  Your receipt will be sent along with conference information.