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
|