M&D PROFESSIONAL SERVICES, INC.

L&R TAX TRAINING SCHOOL

109 WEST TRANSIT ST. ONTARIO, CA 91762

PHONE (909) 986-8372 FAX (909) 986-8375 CELLULAR (909) 908-4978

WWW.MDPROSERVICE.COM

COURSE No. 3016-CE-0002

RENEWAL INCOME TAX COURSE

REGISTRATION FORM

PLEASE READ BEFORE REGISTERING:

Advanced Income Tax Course No. 3016-CE-0002, is a CTEC-approved course which provides 15 hours of federal credit and 5 hours of state credit towards the annual "Continuing education" requirement for tax preparers. A listing of additional requirements to register as a tax preparer may be obtained by contacting CTEC at P.O. Box 2890, Sacramento, CA 95812-2890, toll-free by phone at (877) 850-2832, or on the Internet at: www.ctec.org

Name: _____________________________________________________ Phone: __________________________

Address: ____________________________________________________________________________________

City: _____________________________________________ State: _______________ Zip: _________________

CTEC # __________________________________

( ) Saturday

Classes start: Saturday,October 14, 2006

Classes End: Saturday,October 28, 2006

Class's hours: Saturdays 9:00 AM-12:00M

Lunch 12:00 M- 1:00 PM

1:00 PM-4:00 PM

Fees:

Tuition: $125.00

Payment Method:

( ) Enclosed is $ 125.00 as full payment.

Enrollment Terms:

The courses offered are subject to cancellation or rescheduling in the event of insufficient enrollment. Completion of courses does not guarantee employment, nor are students required to work for School. If for any reason the students are not satisfied, he/she may withdraw prior to completing 10% of the course and receive a full refund (Total payment fees minus books and materials)

Registration, books and material fees are not refundable after the first class session unless the class is cancelled, in which case, upon return of any issued books in reusable condition, all fees will be refunded in full.

I have read and understand cancellation and refund policy as stated above. Please enroll me in the Income Tax Course I have specified. I understand this agreement becomes legally binding instrument upon school's written acceptance of my application for admission.

Signature:____________________________________________ Date:________________________