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IRS W7 FORM
Address: ___________________________________________________________________________________
City: ___________________________________________ State: _______ Zip: _______________
CTEC # __________________________________ E-mail:____________________________________________
PTIN # _______________________________

CLASSES WILL BE HELD AT THE FOLLOWING ADDRESS:

109 W TRANSIT ST. ONTARIO, CA 91762

(  ) Monday, Wednesday and Friday
Start: JULY 10, 2017
End:  JULY 17, 2017
Hours: FROM 6 PM TO 9 PM      


Fees:
Tuition and books: $ 250.00

Payment Method:
(  ) Enclosed is $250.00 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:________________________
109 WEST TRANSIT ST. ONTARIO, CA 91762
PHONE (909)  986-8372 FAX (909) 986-8375 CELLULAR (909) 984-9383
WWW.MDPROSERVICE.COM

COURSE No. K5Y6N-T-00001-12-I,             
IRS CONTINUING EDUCATION
REGISTRATION FORM

PLEASE READ BEFORE REGISTERING:
IRS CONTINUING EDUCATION COURSE No. K5Y6N-T-00001-12-I, is an IRS-approved course which provides 10 hours of federal
credit, 3 hours of Federal tax update credit and 2 hrs ethics credit towards the "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



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