Walt Medak & Associates, Inc., Voice & Data Telecommunications Design & Administration: Order Form

WMA TRAINING REGISTRATION FORM

Classes are held in Portland, OR.

Please note what class that you are registering for:

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DATE OF CLASS:

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NAME:

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TITLE:

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HOW LONG AT THIS POSITION:

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COMPANY:

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ADDRESS:

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CITY:

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STATE & ZIP CODE:

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DAY PHONE NUMBER:

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E-MAIL:

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PBX INFORMATION:

WHAT SWITCH ARE YOU USING?

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WHAT VERSION SOFTWARE ARE YOU USING?

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WHAT TYPE VOICEMAIL?

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PAYMENT:

Payment must be received three (3) weeks prior to class (add $390.75 for the hotel and ground transportation package).

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CHECK BY MAIL PAYABLE TO WMA. CHECK NUMBER

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CANCELLATIONS:

ONLY ACT OF GOD CANCELLATIONS WILL BE ALLOWED; OTHERWISE, NO REFUNDS WILL BE MADE. ONLY RESCHEDULING WILL BE ALLOWED. SUBSTITUTIONS MAY BE MADE BY FAXING THE NAME, ADDRESS AND PHONE NUMBER OF THE REPLACEMENT, ALONG WITH THE ORIGINAL REGISTRANT'S NAME, TO 503.251.2030.