 
|
Registration
Form for
Entrepreneurial Footsteps Distance Course |
Select Course
Required:
|
|
Country |
Course: |
Course
Cost* |
Total
Cost: |
 |
Canada |
E.F.C. course
c/w textbook |
$265.00 Cdn
|
|
|
USA |
E.F.C. course
c/w textbook |
$275.00 Cdn
|
|
|
International |
E.F.C. course
c/w textbook |
$300.00 Cdn
|
|
Note:
Prices subject to change without notice.
* Price includes
course fee, textbook, assignments and S&H if applicable. |
|
First Name: _________________________ Initial:______ Last
Name:_____________________________ |
Address:
_____________________________________________________Apt/Suite
#:_______________ |
City: ______________________________ Prov/State:
_______________ PC/Zip.: __________________ |
Country: _____________________ Email:
_________________________________________________ |
Res.Tel #: _____________________ Bus.Tel #:
____________________ Fax #: ___________________ |
|
Note:
Selected course must be paid
for in full before the course will be shipped to you. Payment is by
certified check, money order or credit card only. No personal checks
will be accepted. Credit card payments will be made in Canadian funds. Your credit
card company will automatically convert to your currency.
|
| The
undersigned hereby acknowledges and accepts full responsibility for
payment of the course and any additional costs including collection agency
costs should my payment not be accepted by my financial institution for
any reason. I have read and accept the terms of the
Refund
and Examination Policies.
Signature:
_____________________________________________ |
| Send
this form to:
Ontario
College of Reflexology
P.O.
Box 220
New
Liskeard, ON
P0J
1P0 Canada
|
Payment
Options:
|
|
|
Certified
Check/
Money
Order:
|
|
|
Amount:
|
$ ____________________________________________ |
|
Credit Card #:
|
______________________________________________ |
|
Exp. Date:
|
______________________________________________ |
|
Signature:
|
______________________________________________ |
|
Name on Card:
|
______________________________________________ |
|