Montana Brittany Club
Rick Smith’s
Pointing Dog Training Seminar
July 22-25, 2010
Near: Bozeman, MT

Enrollment Form
Please enroll me in the following Rick Smith Intermediate Seminar:
July 22-25, 2010 – Bozeman, MT 
Name (as you would like it to appear on Diploma):  ________________________
Name (as you would like us to call you and for it to appear on name tag):  ________________________
Address: _______________________
Phone:   _______________________
E-Mail:  _______________________
Dog Breed/Age: _______________________
Date/Location where you attended Foundation Seminar: _______________________________________________________________

Tuition: $750.00  ($375 deposit will hold your reservation, balance of $375 due by July 1st or you can pay in full now.  Payment will not be cashed/charged until the date of the event.)

Payment of  $__________  by:
a)  Credit Card (circle one:  Visa or MC)  Exp Date:____ Sec.Code: ___
    Number: ______________________________

    Signature: _____________________________

(If using credit card, we need name as shown on card and billing address, if different from above)

Check #: __________ (Payable to Rick Smith - Do not send cash through the mail)  
Mail completed enrollment form and payment to:   
    Bob Myers
    3155 Tizer Drive
    Helena, MT 59602
    (406) 422-0213