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MBE Workshop Order Form


GENERAL INFORMATION

* Required Fields

First Name*

Last Name*

Address*

Address 2

City*

State*

Zip Code*

Shipping Address
(if different from mailing address)

City

State

Zip Code

Daytime Phone*

Evening Phone

Email Address*

How did you hear about us?*:

Other:

Please type the name of your law school below:


BAR REVIEW SESSION

Session*:       Year*:   

State Bar Exam*:   


COURSE OPTIONS


MBE Workshop $295.00
Plus shipping and handling (+$30.00) $

Sub-Total $


Click here to enter your Discount Code:.		 Code:        
 Amount:
  Total $



OTHER BAR REVIEW COURSES TAKEN


Are you currently enrolled with any other supplemental bar review courses? Yes
No

If you checked yes, please select the supplemental MBE course you are currently enrolled in:



If you selected "Other", please list the supplemental course name:

Are you currently enrolled in a full-service bar review course? Yes
No

If you checked yes, please select the full-service course you are currently enrolled in:



If you selected "Other", please list the course name:



ACCOUNT ACCESS INFORMATION

In order to access your account, please assign yourself a username and password.

Username:*

Password:*

Please enter at least 5 characters. Your password is case-sensitive.

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CREDIT CARD

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Select if same as Name above

Cardholder Name:*

As it appears on the card

Credit Card #: Security Code:  

Please do not use spaces or dashes.

Expiration Date: Month: Year:


BILLING ADDRESS

Select if same as Main Address above

Select if same as Shipping Address above

Billing Address

Billing City

Billing State

Billing Zip Code








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