SPRING 2009 ARBITRATION COURSE REGISTRATION FORM

Please complete in full and mail,  fax or deliver to Miskin Professional Corporation, Suite 200, 223 Brock Street North, Whitby ON, L1N 4H6   fax: 905-430-0772

Name _________________________________________________________________

Occupation or Title ________________________________________________________

Company/Organization (if Applicable) ________________________________________________

Mailing Address ________________________________________________________________

Business Phone:  ______________   Home Phone:_________________

FAX: ____________________  E Mail_________________

I hereby apply for registration for the SPRING 2009 Arbitration Course taught by Murray H. Miskin to be held from April to June 2009 with classes every Tuesday and most Thursday evenings plus a day class on a weekend in accordance with the course outline which I have reviewed. I agree to pay the early registration fee of $1250 (plus GST of 5%).  If I withdraw from the course prior to the second class I am entitled to a refund of my fee (less $150 plus GST administration cost) upon return to the instructor of the course book. After the second class I may withdraw and keep the course book, but if I do, I agree to forfeit one half of the full course fee and the full course fee if I withdraw thereafter.  I hereby pay by cheque or by credit card authorization (below) the full amount or at least a $300.00 deposit and agree (and where paying by credit card authorize a further charge) to pay the balance in March 3009 or as will be arranged with the instructor.

   Signature and date:_________________________________________      

Check and Complete as applicable:

____ Cheque enclosed or to follow if form is faxed

____ American Express Card  _____Visa Card _____ MasterCard  _____________________________________  Expiry  __________

Charge the cost to the above credit card: Initial here:  ________

Specify amount of initial payment ($300 or more) __________________________________