Seating is limited! Reserve your place by printing this form, filling it in, and faxing or mailing it today.
Louisville FAX (502)458-3500
2023
____ May 24 & 26 LIVE ONLINE
____ Nov 4 & 5 LIVE ONLINE
Class Time: 9:00AM - 5:30 PM
Price:$175 for prepayment or $200.00 if paid on day of class.***
Maps & Driving Directions
Note: Please clearly print.
Last Name_____________________________ First Name____________________ MI_____
Home Address________________________________________________________Last 4 of S.S.#_________
City_________________________________ State_______ Zip_____________KREC License#____________
Cell Phone ________________________ Home Phone_________________________ Birth Date___/___/____
Principal Broker ______________________________ Make checks payable to: A-Pass-Weikel
Please bill my ___ MasterCard or ___ Visa for the following amount $_______.
Card #:________________________________ Exp. Date______
Signature___________________________ E-mail____________________________________
Note: No refunds for no-shows. Ten minutes late equals a no-show. Refunds are only issued if we receive written notice 24 hours prior to the beginning of class.
Call Today! Louisville: 502-456-1920 *** Lexington: 859-278-0581
Web Site:
www.apassweikel.com *** E-mail: info@apassweikel.com
REGISTER BY MAIL: A-Pass-Weikel Institute, 4400 Breckenridge Lane #310, Louisville, KY 40218