REGISTRATION and TICKET ORDER FORM
Name _____________________________________________________________________
Address __________________________________________________________________
City _________________________________ State _________ Zip _______________
Home Phone ( )________________________________________________________
Email ____________________________________________________________________
Enter number of tickets ordered:
Gold Level Package..........$150 ___
Individual Seminars
Friday Only..................$50 ___
Saturday Only................$60 ___
Both Days...................$100 ___
Plus Children/Teen Seminar...$20 ___ for Adults Only ** Children attend free
VIP Networking Reception.....$35 ___
Luncheon and Fashion Show....$35 ___
Plus USA Woman Pageant.......$25 ___
Dance........................$15 ___
TOTAL: $_________
Method of Payment:
(Check one)
_____ Money Order (No personal checks accepted)
_____ VISA
_____ MasterCard
_____ American Express
Card Number ______________________________________________________________
Name on Credit Card ______________________________________________________
Expiration Date _____________ Signature __________________________________
Mail registration & payments payable to:
Dimensions Plus, P. O. Box 9049, Canton, OH 44711