1-
Fill out ALL appropriate drop-down boxes 2- Print the form
3- Complete the printed form by hand and sign it
3- Mail it with check or fax it with payment information
Student Information (One form per student. Print name as it
should appear on course certificate)
Organization:
Dept./Section:
Student name:
Title:
Work address:
City:
State:
ZIP:
Tel:
Fax:
Email:
How did you learn
about the class?:
Specifics
(keywords, person, etc.)
Payment Information:
Amount: $
Credit card,
check or P.O. No.:
Credit card
expiration date:
Confirmation code (back of credit card):
Make payable to: Edgetech America Inc, P.O. Box 4739, Glen Allen VA 23058-4739, USA * Fax: 804-935-6936
Registration & Cancellation Policies
Training space is limited and is reserved
on a first-come, first-served basis. We require payment or purchase order and
a completed registration form to reserve a space. We confirm ten (10) days
prior to the scheduled starting date. Edgetech is not responsible for
nonrefundable travel arrangement losses resulting from course scheduling
changes or cancellations prior to class confirmation. Tuition includes a
$100 processing fee per class. If registered student cancels five (5)
working days or less prior to class starting date, or fails to appear for
the class, the full tuition will be charged.
I understand and agree to the terms and
conditions of this application.