Fundamentals of Digital Imaging
Registration Form
Last Name: First Name:
Employer:
Address:
City:
State: Zip:
Phone: Fax:
Email Address:
Please Note: Registration for each session is limited to the first 20 applicants.
Please choose your sessions and dates:
 
Part  I  Only  -  Wednesday, July 11, 2012.................................................................$295
Part II  Only  -  July 12 and 13, 2012..........................................................................$495
Part I and II   -  July 11, 12 and 13, 2012....................................................................$595

Registration Deadline is Monday, June 25, 2012
Payment Method: Payment must accompany registration.  Please check one:
 
Please send me an invoice.
I will send in a check with a copy of this completed form.
I will pay by credit card.

Questions? Call Joyce Pollard at 919-515-5435
Total fees:

Please mail your check made payable to North Carolina State University:
 
 NC State University - Engineering Online
Campus Box 7547
Raleigh, NC 27695-7547
Attn: Joyce Pollard