Sky Climber® Facility Training Class Registration Form
Complete (type or print neatly)
this registration form and fax the form to Sky Climber® at (740) 203-3901.
Select the course dates from the class schedule.
Remember, classes fill quickly and reservations are on a “first come,
first serve” basis.
Training Course(s)
Requested:
___ Alpha 1500 Course ___
Applications/Safety & Regulations Course
(1/2-day
duration) (1-day
duration)
___ Compact Series & Alpha 1000 Course
(2-day
duration)
___
˝ - day Training ___ 1 - day
Training ___ 2 - day
Training
($125.00/person) ($200.00/person) ($325.00/person)
___
2˝ - day Training ___ 3 - day
Training ___ 3˝ - day
Training
($375.00/person) ($425.00/person) ($525.00/person)
First Choice (Date): ________________ Second Choice (Date): __________________
Student Information:
Student Name:
_____________________________________________________
Company Name:
___________________________________________________
Address: __________________________________________________________
City:
_________________________________ State:
_______ Zip: ____________
Company Phone:
_______________________ FAX:
________________________
Contact Person: ________________________ Email
Address: __________________________
Payment Method:
______ Check Number: ________ (Make check payable to Sky Climber®, Inc.)
______ Company Purchase Order Number:
___________________
______ Charge Credit Card (circle one) - American
Express, Visa, Master Card
Card
or Account No. _____________________________ Expiration Date: ________
Name
on Card: __________________________________________
Authorized
Signature: ____________________________________
If paying by check, please
mail a copy of completed form and the check to the following address: