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builders@torchlake.com
Fax Back Registration or Home Study Package Order Form

Please print this page and fax back to (231) 938-3374

Would you like to order the Home Study Package or Register for a class? (circle one)

Your Name: ___________________________________________________________________

Street address: _________________________________________________________________

City, State, Zip: _______________________________________________________________

Phone Number: _______________________________________________________________

Email (optional): ______________________________________________________________

CLASS INFORMATION (Do not fill out if ordering a Home Study Package)

Class Location: ________________________________________________________________

Class Date: ___________________________________________________________________

PAYMENT INFORMATION

Check one [ ] VISA [ ] MasterCard

Credit Card Numbers (4 sets of 4): _________________________________________________

Expiration Date on Card: ________________________________________________________

Signature: ____________________________________________________________________

Thank you for your business. Home Study Packages are sent via Priority Mail the date the order is received and you should receive it within 2-3 business days. A class confirmation and map to the location will be sent 10 days prior to the class.