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September 9, 2011 Merced College's - Central Region Consortium

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PAYMENT INFOR��TION (�ayment must be received a minimum of ����� business days before the<br />

������)<br />

Confirming phone registration: #<br />

Check enclosed payable to: <strong>Merced</strong> College Mail to: 630 W. 19 th Street��<strong>Merced</strong>, CA 9534�<br />

Check # Check Amount �<br />

Purchase order attached: #<br />

Invoice my organization. Attention: ��������<br />

Charge to: VISA Mastercard<br />

Card Number<br />

Signature<br />

��������� Expiration Date<br />

Cancellations and Substitutions. Cancellations received up to ����� business days before the ������<br />

are refundable, minus a $�� registration service ���.�After ����������, cancellations are subject to the<br />

entire ������ fee. Please note that if you do�n�t cancel and do�n�t attend, you are still responsible for<br />

payment. Substitutions may be made up to ����� business days before the �������<br />

MERCED COLLEGE<br />

BUSINESS<br />

RESOURCE<br />

CENTER<br />

630 WEST 19TH ST.<br />

DOWNTOWN MERCED<br />

M<br />

C

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