Course Title: _______________________________________________________________
Date/Time: ________________________________________________________________
Cost: __________________
To Register
To
register by mail or fax, please print and complete this form
and send it to the
following address, or fax it to (302) 283-3137.
Delaware Manufacturing Extension
Partnership
400 Stanton-Christiana Road
Suite A-158
Newark, DE 19713
Registration
must be received by the DEMEP at least one week prior to the event. If payment
is not received with this registration form, the DEMEP will send you an invoice
for the total amount due.
Your
registration will be confirmed by fax or email several days prior to the event.
This confirmation will include directions to the event.
Substitutions
can be made at any time. However, registrants who cancel less than one week
prior to this event, or do not attend, will be invoiced for the full amount.
In
accordance with our privacy policy, the following information will be used only
by the DEMEP. It will not be shared with other organizations.
For
more information, call the DEMEP at (302) 283-3131.
Registrant Names:
Titles:
Company
Name:
Street
Address:
and/or
P.O. Box:
City,
State, Zip:
Telephone: Fax:
Email Address:
Check Enclosed:
Credit Card:
Visa
MasterCard
Credit Card Number:
Expiration Date:
Cardholder
Name:
Signature:
Thank you for
your registration.