Print/Fax Registration Form
Print and complete this form.

Fax: (888) 335-3484 or (972) 353-3250
Postal Mail:  P.O. Drawer 141659, Irving, Texas  75014-1659
Overnight Courier (Fed Ex/UPS/DHL): 1216 Chatsworth Court, Colleyville, Texas 76034

 

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Title
(Enter exactly as you wish your certificate of completion to read)
 
Institute  
Address 1  
Address 2  
City   State   Zip/Postal Code  
Country  
Home Phone  
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Fax  
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Please register me for the following courses, subject to your Adminstrative Policies

Course Title
Dates
Location
Tuition
       
       
       
       
       
       
       
Please indicate below your preferred method of payment. Courses tend to fill to capacity early; if your plans are of short notice, please contact us for space availability. Submission of his application does not constitute confirmation of your seat in class. We will confirm your application in writing, subject to space availability and receipt of tuition payment in full. If you are paying by personal check, money order or purchase order, please forward as soon as possible after submitting this on-line form. Note our overnight courier mailing address for non-US Postal Service Express mail.

O  Check
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Credit Card:
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