BECKER LEARNING - Registration Information

REGISTRATION

Note: The following material is provided for you to quickly read on-line.
Download the Becker Learning brochure which contains the Registration Form.

Registration: Please fill out this form for each person attending, and mail along with a Check or Purchase Order (made out to 'Becker Learning') to:

Becker Learning, 5980 Sheppard Road, Dansville, NY 14437

2012 Courses:	[ ] Airside-I	[ ] Airside-II	[ ] Refrigeration	[ ] Systems
(check all that apply)	[ ] Energy Eff. Design	[ ] Products	[ ] Fall 6-night Intro Series

Name ____________________________________________________ Title ____________________________

Company Name ___________________________________________________________

Address _________________________________________________________________

Phone ___________________________________ Email _____________________________________

Authorizing Person

Printed Name

_______________________________________

Signature

________________________________________

Date

_____________

Cancellation Policy:

If someone cancels at least 45 days prior to the start of the class => no cancellation charge.
If someone cancels 21-44 days prior to the start of class => 50% cancellation charge.
If someone cancels less than 21 days before the start of class, or simply doesn't show up => charged the full amount.