REGISTRATION FORM


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First Name
*
Last Name
*
MI
Mail Address
City
State
Zip
Phone Number
Home
Business
Cell
Fax
Email
*
Scheduled Course Date
Payment Choice:Deposit ($125) Full Tuition - Amount Paid: $
Payment*:  (#)

The Agora School of Real Estate accepts Mastercard and Visa payments. If paying by credit card, in order to maintain your personal data secure, you may:
  1. Fax in your order to 239-498-0199 by using this downloadable form in MS Word.
  2. .
I understand that the $125 deposit reserves a place at the selected class. Any and all remaining balances are due and payable at the beginning of the first class. Anyone has until the initial break on the first day to seek a full refund. However, $50 (that covers administration and the cost of text material) will be deducted from the refund.

Please contact us if you have any questions. A confirmation notice will be sent immediately upon verification of deposit or full payment.
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