REGISTRATION FORM:

Being a Leader During Economic Stagnation: 3 Jewels from the Late 1930s

DR. DAN MILLER, HISTORICAL SOLUTIONS LLC

Date: Friday, October 21, 2011 Time: 10am to 1pm

Location: Conference Center, Fort Benjamin Harrison – the Gates Room
5753 Glenn Road
Indianapolis, IN 46216
317-591-0904/Note: Computer mapping will not work. The park entrance is off 59th Street and Post Road, while the Conference Center is located next to the Golf Course.

Cost: $250 per person, includes lunch and one month of individual, confidential follow-up

Your Name:

Your Organization:

Telephone:
Email address:

Please complete and return this registration sheet via email to dan@historicalsolutions.com
If you wish to reach Dr. Miller, you may also call or text at 317-407-3687
Feel free to visit his website at www.historicalsolutions.com

You may pay with either check or cash when you arrive at the session. Checks are to be made out to Historical Solutions LLC. An invoice will be provided upon request. Fee is nonrefundable.

THANK YOU VERY MUCH FOR YOUR INTEREST IN THIS CREATIVE, FRESH, AND UNIQUE APPROACH TO YOUR PERSONAL GROWTH AS A LEADER