registration registration registration A B C D E A B C D E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E PLEASE PRINT CLEARLY A A B C C B D D E E NAME ADDRESS PHONE (INCLUDE AREA CODE) UNIVERSITY NAME A A B C C B D D E E NAME PHONE (INCLUDE AREA CODE) A A B C C B D D E E ADDRESS CITY/STATE/ZIP UNIVERSITY NAME DATE OF GRADUATION A A B C C B D D E E ADDRESS UNIVERSITY NAME A A B C C B D D E E CITY/STATE/ZIP E-MAIL ADDRESS (Please Print E-Mail Address IN ALL UPPER CASE LETTERS.) DATE OF GRADUATION AMOUNT ENCLOSED A A B C C B MONEY ORDER CASHIER’S CHECK D D E E CITY/STATE/ZIP DATE OF GRADUATION A A B C C B D D E E MONEY ORDER A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A B C C B D D E E A A N B B C C L C D E D E X E A A B B C C D D E E N A L C B C E D X E N C L E X Mark Klimek NCLEX Review you plan to attend: REVIEW DATE Mark Check our web site at MarkKlimekNCLEXReview.com Klimek NCLEX Review you plan to attend: for available dates and locations. Mark Klimek NCLEX Review you plan to attend: Check our web site at MarkKlimekNCLEXReview.com REVIEW DATE REVIEW LOCATION (CITY) PLEASE PRINT CLEARLY for available dates and locations. Check our web site at MarkKlimekNCLEXReview.com for available dates and locations. PLEASE PRINT CLEARLY NAME REVIEW DATE REVIEW LOCATION (CITY) PHONE (INCLUDE AREA CODE) REVIEW LOCATION (CITY) DEPOSIT. A seventy dollar ($70), non-refundable deposit is required to register. The non-refundE-MAIL ADDRESS (Please Print E-Mail Address IN ALL UPPER CASE LETTERS.) AMOUNT ENCLOSED CASHIER’S CHECK able deposit can be made by cashier’s check or money order (available at banks, credit unions and ORDER MONEY E-MAIL (Please like Print E-Mail Addressand IN ALLMeijers). UPPER CASEPlease LETTERS.) most ADDRESS superstores WalMart do AMOUNT ENCLOSED not cashtoorregister. a personal Cash CASHIER’S CHECK check. DEPOSIT. A seventy dollar ($70), non-refundable deposit issend required The non-refundand cards not accepted for the non-refundable deposit. able credit deposit can are be made by cashier’s check or money order (available at banks, credit unions and DEPOSIT. A seventy dollar ($70), non-refundable deposit is required to register. The non-refundmost superstores like WalMart and Meijers). Please do not send cash or a personal check. Cash able depositOF canFEES. be made cashier’s check or money order (available atthe banks, and BALANCE Theby balance of the Review fee, $225.00, is due on first credit day ofunions class. You and credit cards are not accepted for the non-refundable deposit. most superstores like check, WalMart Meijers). Please do notPersonal send cash or a personal check. may pay by cashier’s byand money order or with cash. checks and credit cards Cash are not and credit cards are not accepted for the non-refundable deposit. accepted forOF theFEES. balance due. The total cost of thisfee, Review is $295.00. BALANCE The balance of the Review $225.00, is due on the first day of class. You may pay by cashier’s check, by money order or with cash. Personal checks and credit cards are not BALANCE FEES. early! The balance of the fee, $225.00,seating, is due on first day You DEADLINE.OF Register Class size is Review limited by available andthe classes fill of upclass. quickly. accepted for the balance due. The total cost of this Review is $295.00. may pay by check, money order or with cash. are Personal checks and credit cardsthe arefirst not However, ascashier’s long as there is by space available, registrations accepted up to and including accepted the balance due. The total cost of this Reviewintending is $295.00. day of thefor Review. Theearly! Review is recommended to and takeclasses the NCLEX the DEADLINE. Register Class size is limitedfor by those available seating, fill upwithin quickly. next six months. Watch our web site for closure of classes. If a class is full and we are unable However, as long as there is space available, registrations are accepted up to and including the to first DEADLINE. Register early! Class size isanother limited Review by available seating,ofand classes fill up quickly. accept your registration, you may choose or a refund your deposit. day of the Review. The Review is recommended for those intending to take the NCLEX within the However, as long as there is space available, registrations are accepted up to and including the first next six months. Watch our web site for closure of classes. If a class is full and we are unable to day of the Review. You The may Review is recommended for those intending take the NCLEX within the CANCELLATION. cancel at any time before the first day ofto the Review. We encourage accept your registration, you may choose another Review or a refund of your deposit. next sixcancel months. Watch web site for closure of student classes.toIfattend a class is Review. full and we are$70 unable to you to as soon as our possible to allow another the Your deposit accept your registration, you may choose another Review or a refund of your deposit. is not refundable, but you may request a copy Mark’sthe NCLEX Review (a $70 CANCELLATION. You may cancel at any timeofbefore first day of theBook Review. Wevalue). encourage you to cancel as soon as possible to allow another student to attend the Review. Your $70 deposit CANCELLATION. You may at any timeand before first day of the Review. encourage REGISTRATION. Once this cancel registration form yourthe non-refundable deposit areWe received, you will is not refundable, but you may request a copy of Mark’s NCLEX Review Book (a $70 value). you to cancel as soonThis as possible to allow another studentinformation to attend the Review. Your $70 receive confirmation. confirmation includes additional needed to attend yourdeposit chosen is not refundable, but you may request a copy of Mark’s NCLEX Review Book (a $70 value). Review. REGISTRATION. Once this registration form and your non-refundable deposit are received, you will receive Thisaconfirmation includes additional information to attend your chosen Make your checkisorcanceled, money order payable to “Mark LLC”. **In theconfirmation. rare event that Review your deposit willKlimek, beneeded refunded. REGISTRATION. Once this registration form and your non-refundable deposit are received, you will Review. receive confirmation. This confirmation includes additional information toLLC”. attendto: your chosen MailMake this completed form,oralong with your $70 non-refundable deposit, cashier’s check money order payable to “Markneeded Klimek, Make your check or money order payable to “Mark Klimek, LLC”. Sorry, we do not accept personal checks. Review. Mark Klimek P.with O. Box 1 Mail this completed form,oralong your $70tonon-refundable deposit, to: Make your check money order payable “Mark Klimek, LLC”. Cedarville OH 45314 Mark Klimek Mail this completed form, along with your $70 non-refundable deposit, to: P. O. Box 1 Mark Klimek Cedarville OH 45314 P. O. Box 1 Cedarville OH 45314 JULY2013 JULY2013 JULY2013