Reservations can not be confirmed until payment is received.  Mail this form along with a check made payable to the Midwest Society of Professional Consultants (MSPC) or fax with your credit card authorization to:

Sheldon Greenberg                                                                       Print this page
Computer Software Systems, Inc.
838 Leyden Lane
Wilmette, IL 60091        FAX:  847-251-6502

Yes!  I want to be on Board for the Consultant's Cruise on July 13, 2006.  
____   Enclosed is my my check in the amount of:                
____   You are authorized to charge my credit card:                       $__________________

__________________________   ____/____  ______                    Payment By
Visa/MasterCard Number               Exp. Date   Vcode             June 15, 2006   July 10, 2006    

___________________________________________
Authorized Signature            

____________________________________________           $50.00             $55.00
MSPC/MFN Member Name

____________________________________________           $50.00             $55.00
MSPC/MFN Member Significant Other

____________________________________________           $65.00             $70.00
Non-Member/Guest Name

____________________________________________
Address

____________________________________________
City, State, Zip

_____________________     _______________________________________________                  
Phone                                        Fax/E-Mail (for confirmation)

     Return to Home Page