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CompanyDate of Desired ClassContact NameContact Address

Contact PhoneContact Email*Course attendance does not guarantee certificationAttendees must pass certification test. Textbook must beread before attending class to reinforce teaching process.Class will begin at 7am sharp.

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Return completed slipand payment to:

Total # of Attendees ______Check Number ______

BTB3417 Lincolnway EastMishawaka, IN 46544

# of attendees NOT keeping textbook_____X $115=________

# of attendees keeping textbook_____X $145=________

# of textbooks to be mailed_____X $7=________

Total Shipping & Attendance Fees ________Photo ID required at check-in