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 Card No.: Exp.: CCV: Name On Card:			PO# PO Contact: Phone/Fax: E-mail:
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