College Park Clinical Application Workshop Registration Form (*required)
Name *
Facility Name
Address *
City *
State *
Zip *
Country *
Phone *
Fax *
Email *
Certification (if any)
Purchase Order #
Seminar Location


■ Seminars run from 8:00 a.m. to 5:30 p.m.
■ Course fee: $50 per attendee
■ Please complete the registration form, then submit, email, fax or mail to:

    Angela Foster
    College Park Industries
    17505 Helro Drive
    Fraser, MI 48026
    Fax: 800.294.0067
Questions?
Please contact Angela at 800.728.7950 or via email at angela@college-park.com

 
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