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Registration Form |
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Please complete the following:
Name: _____________________________
Company: __________________________
Address: ____________________________
Phone: (Day) _____________ Phone: (Home) _____________
Fax: _____________
Email: ____________________
Website: ___________________
Session Name: ____________________
Date of Session: ____________
Location of Session: ____________
Fee (add GST): $
Credit Card:
Type: ___________ Number: _____________________Expiry: _____
Signature: ________________________________
Today’s Date: _________________
How to Register
To reserve a seat in a training session, copy and past in a word document. Complete this form and fax or e-mail.
If you are paying by cheque (Cheque payable to JJ Carl Smith Consulting); mail your fees with your original Registration Form to the following address at least two weeks prior to the session: |