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ACI Reg Form by c9O41UH8

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									                                                      REGISTRATION FORM
                                                      ACI Field Technician
                                                      Certification Program
                                                              Grade 1
NOTE: Pre-reading requires obtaining the text book TWO WEEKS prior to course start date.
Pre-registration and pre-payment are required TWO WEEKS in advance of the program start date.

This is not a training program for Testers. Experience in concrete
testing is recommended.
Authorizing Name:       _________________________________________
Company Name:           _________________________________________
Company Address:        _________________________________________
City:   _____________________________ Postal Code: ____________
Phone Number:           ________________    Fax #: _________________
Email: _____________________________________________________
Registrants Names:      _________________________________________
                        _________________________________________
Registration Fees:
Members:             $460.00 + G.S.T. =     $483.00
Non-Members:         $660.00 + G.S.T. =     $693.00
Location (Please check)        _____ Edmonton     ________ Fort McMurray
                               _____ Calgary
Method of Payment:
Cash: ___ Cheque Enclosed: ___ Invoice __________ PO# ___________
MasterCard / Visa:
Cardholder’s Name: __________________________________________
Card #:__ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Expiry: ___ / ___


                                          NO REFUNDS

                  Please fax, mail or email completed registration form to:

                          Alberta Ready-Mixed Concrete Association
                           9653-45 Avenue, Edmonton AB T6E 5Z8
                           Phone: 780-436-5645 Fax: (780) 436-6503
                                        info@armca.ca

								
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