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Training Registration Form

Student Information

First Name:

Last Name:

Title:

Company:

Email:

Phone:

Fax:

Address:

City:

St/Prov:

Zip/Post Code:

Country:

PO#:

Booked by:

(your name if not registering for self)

Your Phone #:

I would like to register for the following course(s):

Enter Course Name		Enter Course Date

Optimizer Version:

V5 V6

PLC:

A/B PLC5 RSLogix5000

System:

Linear Transverse

Price:

$US $CDN

A Coe Newnes McGehee representative will contact you directly to confirm your request, finalize your registration, and collect payment information.

* If you wish to register for a class less than five (5) business days prior to the course start date, please call us directly to ensure your registration. Call 250.833.3097 or 250.833.3042 for more information on training courses.