Alan Kells Log
Alan Kells Schools of Real Estate

Registration Form

Name ___________________________________

Social Security# ________________

Address __________________________________________________

City, State, Zipe Code _______________________________________

Home Phone___________________ Cell Phone _________________

E-mail ___________________________________________________

LOCATION:

EAST/DAY EAST/WEEKEND ERIE
HARRISBURG   MAIN     NORTH
SOUTH WEEKEND

R. E. Fundamentals Date _______________ Cost $178
R. E. Practice Date ___________________ Cost $178
Textbook and Materials (one time fee for both classes) Cost $49.00

Payment:

Check (made payable to Alan Kells Schools)

MasterCard Visa Account Number _________________________
(circle one)
Expiration Date___________________________

Signature_________________________________

Mail this form with payment to:
Alan Kells Schools of Real Estate
119 Gamma Drive
Pittsburgh, PA 15238

How did you hear of Alan Kells Schools of Real Estate?_____________________________

________________________________________________________________________

    Alan Kells Schools of Real Estate, Inc.