Educational & Motivational Symposium 2012 | July 28 – July 30

REGISTRATION INFORMATION FORM
Early Bird Registration: Only $299.00 | Ends March 26, 2012
General Registration: $399.00 | March 27 – June 29, 2012
General Student Registration: $329.00
Late Registration: $499.00 | After June 30, 2012

Registration fee includes: Six (6) Classes, Complete Curriculum,
Networking Reception, Opening & Closing Ceremonies, Lunch (Sun),
The Black & White Ball (Dinner-Dance) Ticket
Please note: Completing this registration form does not reserve your hotel room. All hotel reservations must be made directly to the Sheraton Greensboro at Four Seasons. 1.800.242.6556
Cell #
I am a:

(if other please specify)


(if yes what is your distributors name?)
Cancellation Policy: For registration cancellations prior to or on June 29, 2012, a
$50.00 fee will be charged. To receive a refund less the $50.00 fee, cancellations must
be in writing or emailed to events@dudleyq.com or faxed to 1.888.573.8210.
Cancellations will not be accepted by phone.
No refunds or credit for cancellations or no shows will be given after June 29, 2012.
 
Please submit form and representative will contact you for credit card information.
Once the registration fee has been paid, you will officially be registered for
Dudley’s EMS 2011.
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Dudley Beauty Corp, LLC | 4035 Premier Drive | Suite 109 | High Point, NC 27265 | www.Dudleyq.com