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REGISTRATION
FORM |
| Print
the form below and submit by fax: 240.465.0365. If paying by check,
fax form, then send a follow-up letter to KIND with the check by regular
mail to KIND Technology, 12605 Lloydminster Drive, N. Potomac, MD 20878. |
| Name: |
| Home Address: |
| City, State,
Zip: |
| Home Phone: |
| Company Name: |
| Company City,
State, Zip: |
| Company phone: |
| Company Fax: |
| E-mail: |
|
| I would
like to sign up for the following class or classes: |
|
| Select
Payment Method: |
 |
Check (payable
to KIND Technology) |
| |
Bill Company
Listed Above, PO # __________________ |
| |
Visa |
| |
MasterCard |
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| |
| Card
# |
| Expiration
Date: |
Amount: |
| Signature: |
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12605 Lloydminster Drive ~ North Potomac, Maryland 20878 ~ Phone: 301.590-0011
~ Fax: 240.465.0365
|