DATE_________________ 20 _____
NAME___________________________________________________________
ADDRESS________________________________________________________
CITY______________________________ STATE_______ ZIP______________
Upon Initial Enrollment In This Course, Payment Is Required For The Following:
Module One, Electrical Fundamentals |
$100 |
One-Time Registration Fee |
$15 |
Shipping and Handling |
$5 |
TOTAL |
$120 |
MAIL COMPLETED ENROLLMENT FORM WITH CHECK, MONEY ORDER OR CREDIT CARD INFORMATION TO:
TECHNICAL TRAINING ASSOCIATES
HC 70 BOX 3172
SAHUARITA, AZ 85629
APPLICANT STATEMENT: I have read and understand the fee schedule and terms and conditions.
_________________________________________________________________________
(Applicant Signature)
| FOR CREDIT CARD ORDERING, FILL IN INFORMATION BELOW | |
| Visa
_____
MasterCard_____
Name on card ______________________________________________________ Account Number ______________________________________________________ Expiration Date ______________________________________________________ Authorized Signature ______________________________________________________ |
Credit
card orders may be submitted by mail to the above address or by fax to:
(520) 648-3334 Please fax or mail this this information along with your enrollment form.
|