Technical Training Associates

Workshop Registration: Appliance Service Workshop

Nashville, Tennessee: March 8th & 9th, 2010

COMPANY OR AGENCY____________________________________________

STREET ADDRESS _______________________________________________

CITY ________________________________STATE _______ ZIP___________

Phone ___________________________ FAX____________________________

ATTENDEES:

Name: ___________________________________________________________

Name: ___________________________________________________________

Name: ___________________________________________________________

Name: ___________________________________________________________

WORKSHOP FEE: $295 Per Person

Check, Money Order, Visa or MasterCard Accepted.

Purchase orders accepted from Public Schools, Universities, Colleges and Government Agencies.

PO#________________ OR, CREDIT CARD INFORMATION: ___ Visa      ____MasterCard

CARD # ___________________________________EXP. DATE ________

SIGNATURE __________________________________________

To Register By Regular Mail, Send This Form With Payment Or PO# Information To:

Technical Training Associates, HC 70 BOX 3172, Sahuarita, AZ 85629

Or, You May Use This Form To Register By Fax To 520-648-3334

Call 520-625-6847 to register by phone.