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 COOKSEY[1] & ASSOCIATES
1400 S. Valley View Blvd.  Ste. 1002
Las Vegas, NV 89102

702-254-6092

 

COMPANY NAME:

COMPANY ADDRESS:

PHONE:

EMAIL:

AUTHORIZED COMPANY REPRESENTATIVE:  (Name & Title)


LOCATION OF EVENT:

DATE OF EVENT:  (Day, Week, Year)       

ANALYSTíS BEGINNING TIME:†††††††††††††††††††††† ANALYSTíS ENDING TIME:

CONTACT PERSON (at event):

PAYMENT: 

$300.00 up to two hours, $120.00 each hour thereafter

25% discount shall apply after the second hour when full payment is received in advance at the time of booking.

PAYMENTBALANCE (if not paid in advance) TO BE PAID BEFORE THE PERFORMANCE BEGINS:

 

NOTE:  I am the company representative (and/or owner), responsible for authorizing payment.  My signature below verifies my understanding and agreement that three hundred dollars ($300.00) shall be non-refundable.††

SIGNATURE:

 

 

 

 

 



[1] Event Reservation will be official only when this document and payment is received by Cooksey & Associates in Postal Mail, Fed. Ex., UPS, etc.You will receive confirmation by email.Please make check to BILL COOKSEY.Thank you!