Course Registration Form - MicroAge

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Course Registration Form - MicroAge

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Student Email: Contact Name: Contact PH#:. Contact Email: ... Saskatchewan | S4P 4K5 | Tel: 306-566-4528 | Toll Free: 18

Course Registration Form

Registration Date: ____________________________________________ Class Date: _________________________________________________ Class Name: ________________________________________________

Student Name: __________________________________________________________________ Student PH#: ____________________________ Student Email: __________________________

Contact Name: __________________________________________________________________ Contact PH#: ____________________________ Contact Email: __________________________

Company/Organization Name & Address: _______________________________________________________________________________________ _______________________________________________________________________________________

Invoice to address above: Yes

No

If NO specify the correct address below: _______________________________________________________________________________________ _______________________________________________________________________________________

Bill to: (name on invoice to) _______________________________________________________________________________________ GST Exempt: Yes

No

GST# __________________________________________________________

PO Required: Yes

No

PO# __________________________________________________________ Print Form

104-1777 Victoria Ave | Regina Saskatchewan | S4P 4K5 | Tel: 306-566-4528 | Toll Free: 1800-489-7754 | Fax: 306-569-2118