SIG/COM 

 

36254 Kenai Spur Highway, Suite 1

Soldotna, Alaska 99669

Phone:  (907) 262-3838

Fax:  (907) 262-1081

Class Fee:  $1,700.00 / student

Training Class Registration Form

Company Name:___________________________________________________

Billing Address:____________________________________________________

Contact Person:________________________   Title:______________________

Phone:_________________   Fax:______________   Email:________________

Purchase Order #:_________________   Purchase Order Amount:___________

Participant Name (1):_______________________   Phone:____________

          Participant Name (2):_______________________   Phone:____________

          Participant Name (3):_______________________   Phone:____________

          Participant Name (4):_______________________   Phone:____________

 DMS-10 Class:_____  Date:______________

 GX5000 Class:_____  Date:______________

 REGISTRATION POLICIES

        Cancellations must be done three (3) weeks prior to class date.

        Reschedules made less than three (3) weeks prior to class date will result in a 5% change fee.

        All refund requests must be done in writing and will be assessed a 20% administrative fee.

By signing below, I am indicating that I have read and understand the above SIG/COM Registration Policies.

_________________________________                  _____________________

Name                                                                                                          Date

 Please return completed registration form to Teresa Gamble at:

 (907) 262-1081 or

Signal Communications, Inc.

36254 Kenai Spur Highway, Suite 1

Soldotna, AK 99669