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Training Class Registration Form
ENROLL BILL TO (Please print or type) (If different from ENROLL)
Name______________________________________ Name______________________________________ Title_____________________________________ Title_____________________________________ Company___________________________________ Company___________________________________ Street____________________________________ Street____________________________________ City______________________________________ City______________________________________ State_________________________Zip_________ State________________________Zip__________ Phone_____________________________________ Phone_____________________________________ Fax_______________________________________ Fax_______________________________________CLASS REGISTRATION
Class Title__________________________________________________________________ Class Date___________________________________________________________________ Class Location_______________________________________________________________CHOOSE METHOD OF PAYMENT
__ Check enclosed, payable to Unify Corporation __ Purchase order enclosed P.O. No.______________________ (Terms: NET 30) __ Charge to my: __ MC __ VISA __ AMEX Card Number _______________________________ Expiration Date ____________ Cardholder Name ___________________________ Signature__________________________________