Course Registration

Course Registration

If you wish to use a credit card, we will take your credit card number by fax or phone. Please do not enter your credit card number on this form. Call 978.250.4983 or fax to 978.250.4372 all card numbers.

Fields marked with * are required.

Course 1 Information

*Course:

*Location:

*Start Date:
Please check the schedule for correct start dates.

Course 2 Information

Course:

Location:

Start Date:
Please check the schedule for correct start dates.

Company Information

*Company Name:

*Address:

*City:

*State/Province:

*Country:

*Zip/Postal Code:

*Phone Number:

Fax Number:

Corporate PO#:

Your Information

*First Name:

*Last Name:

*Job Title:

*Phone Number:

*E-mail:

How did you find our site?

Student Information

*First Name:

*Last Name:

*Job Title:

*Phone Number:

Fax Number:

*E-mail:

Click here if this address is the same as the company address

*Address:

*City:

*State/Province:

Zip/Postal Code:

Student 2 Information (if applicable)

First Name:

Last Name:

Job Title:

Phone Number:

Fax Number:

E-mail:

Click here if this address is the same as the company address

Address:

*City:

State/Province:

Zip/Postal Code:

Payment

If you are paying by check, please mail a printed copy of this form to:
Software Skills Training, Inc.
PO Box 156
Chelmsford, MA 01824

Please call us at 978.250.4983 if you're paying with a credit card. We accept American Express, Discover, and VISA.

Comments:

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