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SUNTRAC SERVICES, INC

Radiological Training Registration

 

To register, complete information and Fax or e-Mail to Brenda@Suntrac.com

 

Suntrac Services, Inc.

1818 East Main Street

League City, TX 77573

Tel: (281) 338-2133  Fax: (281) 338-2136

 

 

Registration Form

Attendee

Course #

Date

 

Company Name:

Address:

City:    State:    Zip:

 

Phone#:    Fax#:    

E-mail:

 

 

If a registrant is unable to attend a course, a substitute may attend in the place of the original registrant.  However, if a registrant is unable to attend and no substitute is made, a course cancellation must be made 14 calendar days prior to scheduled course date.  Cancellations made less than 14 calendar days prior to course date are subject to be charged a 25% cancellation fee per registrant.  Course fees are non-refundable for registrants failing to cancel prior to the start of the course.

Charge Credit Card

Purchase Order

Visa  MC  Amex  CC Address Same
Card No.:                                              As above

Exp.:  CCV:

Name On Card:

 

PO#
PO Contact:
Phone/Fax:
E-mail:

 

**If you plan to bring your credit card to the class no need to fill out the credit card section.**

Please send in this registration form to participate in the training class. You will receive a confirmation by either e-mail or phone. 

If you do not hear from us within 3 days, please give our office a call

 

1818 EAST MAIN STREET
TEL: (281)338-2133

 

Email: brenda@suntrac.com

LEAGUE CITY, TX 77573
FAX: (281)338-2136