Accent Training, Rochester NY
Text Box: Payment: Class size is limited. Please register by phone, fax, mail or e-mail. We accept cash, business checks, VISA, MasterCard, Discover, Novus, or American Express. Registrations must come from businesses or organizations. Please send one registration per person First Name _________________ Last Name ____________________________ Company or Organization _____________________ Dept. __________________ (Business) Phone ( ) ____- _______ (Home) Phone ( ) ____- ________ Address __________________________________________________________ City ____________________ State ___ ZIP __________ Course ___________________ Dates ____&____ Times ___-___ Cost _____ Course ___________________ Dates ____&____ Times ___-___ Cost _____ Course ___________________ Dates ____&____ Times ___-___ Cost _____ Enclosed: Check # ____ or P.O. # ________ Dated __/___/__ Total _____ Credit Card No. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Name on Card ________________ __ ________________ Expires ___/___ ü q VISA q NOVUS q DISCOVER q MasterCard q American Express 3-Digit code on back of Card ______ Billing zip code ___________ Authorizing Signature ___________ __ ________________ Date ___/___/___ Cancellation: Class size is limited please call immediately if you cannot attend so someone else can take your place. Full refund is given only if Accent Training is notified of cancellation by letter, fax, or phone at least 5 business days prior to class. (Ask about exceptions for registrations 4 days or less prior to class.) If you do not attend and we are not contacted as stated above, we will not refund. However, you can substitute another class within 60 days for a 25% Registration fee. Accent Training reserves the right to cancel any course. If Accent Training cancels a course, a full refund or full credit toward another class can be requested. Mail to: Fax to: Accent Training (585) 247-5833 Gateway Plaza E-mail to: 2352 Lyell Avenue accent_classes@yahoo.com Rochester, NY 14606

Registration Form