|
Course:
|
Program Monitoring &
Self-Assessment |
|
*
Course Date::
|
|
|
Cost of Class:
|
$325
per Student |
|
*
Number of Students Required:
|
|
|
Discounts: |
When
registering online, Early
Bird Discounts are only available with
Credit Card registrations!
Take
3 discount is for 3 or more student
registering for the same workshop. |
|
Total Cost:
|
|
|
Student Information
|
|
*
Name:
|
|
|
*
Job Title:
|
|
|
*
Company:
|
|
|
*
Email:
|
|
|
*
Phone:
|
|
|
Fax:
|
|
|
Address:
|
|
Additional
Students
Fill in the
following fields depending on how many seats
you require.
|
Classes
are occasionally cancelled. Please
indicate if there is a second date in
our schedule which may be acceptable
to you. You will not be enrolled in
this class without a confirmation by
phone and/or email or fax. Please read
the cancellation
policies.
|
Course
Date::
|
|
|
Billing Information
|
|
*
Method of Payment:
|
PO# |
|
|
Please bill the company: letter of authorization or
purchase order will be faxed to (901) 758-4036. I have
read and understand the registration
and refund procedures for HSU courses. |
|
Card
No.
Expiration
Date |
|
Authorizing Manager:
|
|
|
|
Check
this box if your billing address is the same as
your personal information. |
|
|
|
Additional Comments
|
|
|
