First and Last Name(s)*

Seminar Date*

Session (1:30 p.m. or 7:00 p.m.)*
1:30pm7pm

Seminar Location*
- Select One -BETHESDA, MDCOLUMBIA, MDFAIRFAX, VAGAITHERSBURG, MDRESTON, VASILVER SPRING, MDSPRINGFIELD, VATYSONS, VA

Total Number in Party*

Are you already a client of The Collins Firm?*
YesNo

Phone Number

Your Email*

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