PACS Course Number 340
-- REGISTRATION FORM --
Register by making a copy of this form and send it complete with contact and payment infomration to the address below. The course fee is $1995 to secure your attendance. Please list your special interest on the registration form below.
| PACS Course City and Date(s): | |
| Check or PO # | payable to PACS, Inc. |
| Credit cards accepted - provide card information: number, expiration date, and name on card. | |
| Name: | |
| Job Title: | |
| Company: | |
| Postal Address: | |
| Telephone: | |
| Best Hours Reached: | |
| E-mail Address: | |
| Special Interest: | |
| Please mail this form with payment information to: | |
| PACS, Inc. • 409 Meade Drive • Coraopolis, PA 15108 | |
| Telephone: 1.800.367.2587 | Fax: 1.724.457.1214 |
| Website: http://pacslabs.com | E-mail: |