EXCEPTIONAL RESULTS FROM HANDS-ON INSTRUCTION                                                 For more information call AIA Centers:CANADA: 403-879-2477; US: 860-264-5505
ATTENDEE INFORMATION :PLEASE PRINT CLEARLY

 

First Name      __________________________________________________________________

Last Name      __________________________________________________________________

Company         __________________________________________________________________

Address1         __________________________________________________________________

Address2         __________________________________________________________________

City _________________ State/Prov.  _________ USA __    CANADA __

Zip/Postal Code  _________

Phone-Home (_____) ____________________

Phone-Mobile (_____) _____________________

FAX (_____) ______________________

Email ________________________________________

Course Name    _______________________________________

Course Date ____________________

Course Location: Ardmore___ Calgary___ Gulf Breeze___ Other_______________

Course Fee $_________

Payment Method: Visa       #___________________________________________________________

EXP:___/___ Security Code______

Cheque      *Please make cheque payable to AIA Centers & send to 248 Torresdale Avenue, Toronto ON Canada M2R 3E8 

Other  ______________________________________________________________________________________________

*Please confirm other methods of payment with AIA prior to registration

 

By submitting this registration, I acknowledge that I have read and agree with the

AIA CENTERS Cancellation/Refund Policies as posted on www.AIAcenters.com

Thank you for your registration!

CONFIRMATION WILL BE SENT TO YOUR EMAIL ADDRESS

 

AIA Centers: CANADA: 403-879-2477; US: 860-264-5505

Mailing Address: 248 Torresdale Avenue, Toronto ON Canada M2R 3E8