The Education Program for
Photonics Professionals
Registration
Fax: (519) 746-8115 Mail: EP3 / Dr. D. Strickland
Attn: Dr. D. Strickland UW Physics Department
200 University Ave. West
Waterloo, ON
N2L 3G1
Title: Mr. Mrs. Ms.
Forename(s): _________________________________________ Surname: ___________________
Education: _______________________________________________________________________
Affiliation: Private Corporate, Company: ____________________________
Mailing Address: _________________________________________________________________
_________________________________________________________________
Phone(s): ____________________________________________________
Fax: ________________________________________________________
Email: _______________________________________________________
Course Selection: Introduction to Optics Radiometry & Photometry
Physical Optics Lasers & Electro-optics
Optical Design Optical Communications
Total Cost @ CDN $1,667 per course: ___________________________
Payment Option: Cheque included, payable to “The University of Waterloo”
Credit Card: Visa MasterCard
Name: ________________________________________
Number: ______________________________________
Expiry: _______________________________________
Signature: ______________________________________
Invoice the Company, Contact: __________________________________
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Additional Notes: __________________________________________________________________
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