|
Burk Baker School of Real Estate & Appraising 2834 S. Sherwood Forest Blvd., Suite B-14 Baton Rouge, LA 70816
Baton Rouge 225-293-6000 / Nationwide 800-222-3295
REGISTRATION FORM Name: __________________________________________________________ Address: ________________________________________________________ ________________________________________________________ ________________________________________________________ Email Address: __________________________________________ Home Phone: (_____)___________________ Cell: (_____)___________________ Starting Date: _______________ Day ____ Night ____ Location: Baton Rouge____ Lafayette____ Monroe____ Metairie____ Lake Charles____ Mandeville/Covington____ Amount enclosed: __________ Check # __________ Credit Card: ___________________________ Expiration Date: __________ Have you been convicted of a crime, felony, or misdemeanor? ____Yes ____No Driver's License # _______________________
|
|
|