Please fill out this entire form carefully and completely. All fields are required. When you have completed the form, please hit the SUBMIT button and you will be taken to the PayPal page for payment. You will receive a confirmation email from Robert within 48 hours. Thank you!

First Name:

Last Name:

Email Address:

Mailing Address:

Name of Program:

Date of Program:

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Human Verification: What is the numeric value of three plus four ?

Your information will be held in the strictest confidence and will never be given, rented, or sold to anyone, ever!

Please note that all Programs are exclusive and thus limited to a small number of people; therefore, all payments are non-refundable. If you are unable to attend for any reason, you may send someone else in your place.

When you hit the SUBMIT button you will be taken to the PayPal page to make full payment.