Training Course Registration Form

Document Sample
Training Course Registration Form Powered By Docstoc
					a) Pavement Design & Analysis Training Course                                                 (tick appropriate box with X)
   Pretoria, 22&23 February 2011
   Cape Town, 14&15 July 2011
   Durban, 27&28 October 2011

b) Rubicon Toolbox Dataviewer Training Course                                                 (tick appropriate box with X)
   Pretoria, 10 June 2011

c) Pavement Condition Analysis & Rehabilitation Design Training Course                        (tick appropriate box with X)
   Cape Town, 30&31 March 2011
   Durban, 19&20 May 2011
   Pretoria, 10&11 November 2011

2. Details of Delegate(s):
   Delegate 1 (as to be displayed on certificate)                                   E-mail:
   Mobile Phone Number
   Delegate 2 (as to be displayed on certificate)                                   E-mail:
   Mobile Phone Number
   Delegate 3 (as to be displayed on certificate)                                   E-mail:
   Mobile Phone Number

3. Please specify dietary preferences &                                             Type of preference:
   allergies (For example: Halaal / Kosher)                                         Nr of attending delegates with above mentioned preference:

4. Company Details
   Name of Company
   VAT number
   Contact Person for Invoices                                                      Title:                       Name:
   E-mail Address
   Physical Address
                                                                                    Postal Code:
   Postal Address
                                                                                    Postal Code:

   VERY IMPORTANT:
1. Participants are to bring their own laptop computers, adaptors and two-point plugs
2. Temporary licences for the Rubicon software will be issued as part of the course fee to allow all participants
   to complete practical tutorials
3. Completion of this form acts as confirmation of attendance. Should a delegate complete this form and not
   inform us at least one week in advance that he/she will not attend, the full training course cost will be payable

              Please email the completed registration form to marloub@tiscali.co.za or fax to 088 012 734 0062
                    TRAINING COURSE REGISTRATION FORM
a) Pavement Design & Analysis Training Course                                                       (tick appropriate box with X)
   Pretoria, 24&25 May 2012
   Durban, 19&20 July 2012
   Cape Town, 14&15 November 2012

b) Rubicon Toolbox Dataviewer Training Course                                                       (tick appropriate box with X)
   Pretoria, 14 September 2012

c) Pavement Condition Analysis & Rehabilitation Design Training Course                              (tick appropriate box with X)
   Durban, 14&15 March 2012
   Cape Town, 20&21 June 2012
   Pretoria, 4&5 October 2012

2. Details of Delegate(s):
   Delegate 1 (as to be displayed on certificate)                                               E-mail:
   Mobile Phone Number
   Delegate 2 (as to be displayed on certificate)                                               E-mail:
   Mobile Phone Number
   Delegate 3 (as to be displayed on certificate)                                               E-mail:
   Mobile Phone Number

3. Please specify dietary preferences &                                                       Type of preference:
   allergies (For example: Halaal / Kosher)             Nr of attending delegates with above mentioned preference:

4. Company Details
   Name of Company
   VAT number
   Contact Person for Invoices                          Title:                       Name:
   E-mail Address
   Physical Address
                                                                                                Postal Code:
   Postal Address
                                                                                                Postal Code:

   VERY IMPORTANT:
1. Participants are to bring their own laptop computers, adaptors and two-point plugs
2. Temporary licences for the Rubicon Toolbox software will be issued as part of the course fee to allow all participants to complete
    practical tutorials
3. Completion of this form acts as confirmation of attendance. Should a delegate complete this form and not inform us
   at least one week in advance that he/she will not attend, the full training course cost will be payable

        Please email the completed registration form to marlou@rubiconsolutions.co.za or fax to 088 012 734 0062

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:17
posted:9/8/2012
language:English
pages:4