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Open Enrollment Registration Form

Company/Organization Information

Company/Organization Name
Your Name
Your Phone
Your E-mail
Street Address
City, State, Zip

Registration Information

Is this an Enrollment Retake Cancellation

Student Name (1)
E-mail
Course Name & Level
Date
Time
Price (Click Here to View Pricing)
   
Student Name (2)
E-mail
Course Name & Level
Date
Time
Price (Click Here to View Pricing)
   
Student Name (3)
E-mail
Course Name & Level
Date
Time
Price (Click Here to View Pricing)
   
Student Name (4)
E-mail
Course Name & Level
Date
Time
Price (Click Here to View Pricing)
   
Total Price*

* If unsure of price contact your Account Executive.

Additional Information


Payment Information

(Choose One)

Club Member   

Coupon Holder

Credit Card

Type of card
Card Number
Name on Card
Exp. Date
Last 3 Digits

 

Invoice

Company Name
Company Address
Name of Individual to Invoice
Email of Individual to Invoice
PO Number (if needed)

 

Payment is due 15 days from the
date of this enrollment request.


Cancellation Policy
If you cancel or re-schedule a class, you must do so at least three days before the course for desktop application courses or ten days before the course for technical courses to receive full credit or refund. If you cancel or re-schedule within the 3 or 10 day periods,  you will be charged for the course.  However, you will be allowed to take the class, on a space available basis, the next time that it is offered at no additional charge. Please note that courses may be added, deleted, or rescheduled based on demand or circumstances beyond our control.

 

I have read and agree to the cancellation policy stated above. 

 

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Please only click the Send Registration button once, it may cause a duplicate registration. 
 

Thank you!

 

 

 

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1050 Chinoe Rd. Suite 208  Lexington, KY 40502