APICS Phoenix Chapter #58


CPIM Certification Review Course Registration Form

Make Reservation        Cancel Reservation

A separate Registration Form is required for each course!

SELECT COURSE LOCATION DAY/TIME DATES EARLY REGISTRATION
Mon & Thurs
5:00 - 8:00 pm
7/10/08 - 8/4/08
7/3/08
Mon & Thurs
5:00 - 8:00 pm
9/4/08 - 10/2/08
8/28/08
Mon & Thurs
5:00 - 8:00 pm
10/27/08 - 11/24/08
10/20/08

* Registration after this date is available.  It is listed for scheduling and In-house pricing purposes.
**Course will be rescheduled if there are less than 5 participants**

* denotes required field or selection

Name: *

Company Name:

Email: *

Mailing Address: City: State: Zip: *

Phone#: *            Fax#:

Member Type:*

* NOTE:  The fees noted below do not include the mandatory Participant Guide, which must be ordered separately from APICS Society. 

APICS or  ISM or  IMA MEMBER - $350.00  Member#: Exp:
          Membership number must be provided. 

STUDENT MEMBER - $150.00    Member#: Exp:
          APICS Student Membership number must be provided.

NON-MEMBER - $565.00 - Includes 1-year membership (effective within 2 weeks after class start, processing of payment, and receipt of a fully-completed membership application at the Chapter Office)

 

Payment Type:

        Please Charge My: Card #: Exp:

             IMPORTANT: The Chapter does not accept American Express or Discover at this time.

Note:  The Chapter can not provide a secure data transmission at this time.  As alternatives:  1) If you have previously registered for a class and paid with a credit card, note "Credit Card on File" in the comments below; or 2)  If you have not previously registered for a course, submit the on-line registration form without your credit card number.  Print out your registration confirmation form, note your credit card number on the form, and fax it to the Chapter's dedicated fax line at (480) 813-2154.  

        Pay By Check - Payable to: APICS Phoenix Chapter #58 - Mail your payment to the address noted on your registration confirmation.

Comments or Questions:

By submitting below I acknowledge that I have read the cancellation policy and agree to abide by its terms and conditions.  In addition, I authorize the chapter to accept payment or charge my account as noted above.