NOTEBOOK ORDER FORM

All attendees will receive the conference notebook free of charge at the meeting. Non-attendees may order notebooks and attendees may order additional copies :
1 Notebook* - $225
2 Notebooks* - $395
3 or More Notebooks* - $165 per title *Notebooks for our ANNUAL BANK TAX INSTITUTE - $295 each

I would like to order the Book/Notebook title:

Quantity:

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SHIP TO INFORMATION

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Name*:
Job Title*:
Company*:
Street*:
City*:
State*:
Zip*:
Country:
Phone*:
Fax:
Email Address:

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Payment Information:

Purchase Order Number (optional)

I am using the credit card listed below (Please Include the 3(4) digit Verification code on your card).
Please invoice me
Please call me for credit card information at:
I will fax Credit Card information to 1-800-250-3861/1-860-701-5909
EFT (Electronic Funds Transfer) Contact us for information.
I will mail a check with a printout of this form to:

Executive Enterprise Institute
Two Shaw's Cove,
New London, CT 06320-4675

Credit Card Information:
Note: (This information will be transmitted securely for your protection)

Visa	MasterCard	American Express	Diners Club
Card Number:		Card 3(4) digit Verification Number:		Exp. Date:
Name of Card Holder:		Is this a corporate card? yesno

Is billing name different from the shipping information above? Yes No. If so, please fill out the following:

Name:		Job Title:
Street:
City:		State:		Zip:
Country:

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Use the comment box below to provide us any additional information information.

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4 WAYS TO CONTACT EEI

MAIL: ExecutiveEnterpriseInstitute Two Shaw's Cove New London CT 06320-4675

PHONE: (800) 831-8333 Inside US (860) 701-5900 Outside US

FAX: (800) 250-3861 Inside US (860) 701-5905 Outside US

EMAIL: info@eeiconferences.com