Promotional Workshops

1. Please Indicate Which Location You Will Attend:

	To Be Announced.
	To Be Announced.
	To Be Announced.
	To Be Announced.
	To Be Announced.

2. Sign Up For:

Assessment Center Seminar    $100.00

Simulator Workshop    $100.00

Total:

3. Method of Payment:

*Cancellations must be made up to one week prior to scheduled class date.
No refunds will be made for “No-Shows”. You may
be able to attend another scheduled class, space provided.

Check Mailed - Please include payment with copy of Registration Confirmation.

Visa or Master Card (4% service charge will be added)

Pay at The Door, Cash or Check $110.00 per Class Day

Bill My Department - Must have Department PO

* Arrangements must be made directly through me by email or by phone.
** Must have Department PO

4. Student Information:

First/Last Name:
Address:
City:
State:
Zip:
Department:
Phone #:
E-mail Address:

Billing Information

First Name:

Last Name:

Company (optional):

Street Address:

Street Address (2):

City:

State/Province:

Zip/Postal Code:

Country:

Phone:

Credit Card

Credit Card Number:

Expiry Date: /

CHUCK WILSON
77-263 Maliko Street
Kailua Kona, Hawaii 96740
For Info: (310) 261-7795
Fax: (808) 322-7009
cwilson@promotionalworkshops.com

E-mail

Site design by: