Please complete all the instructions carefully, print a copy of this form and FAX everything to 530-873-6697. Your registration is not valid until we receive this information and send you a confirmation. Confirmation may take up to 48 hours, depending on the demand. Please be patient. Also, please fill out the Contact Information.
Session Title: Month/Year: Your Full Name: Your Email: Affiliation: Work Phone: Fax Number:
Checks or money orders must be in U.S. funds, and drawn against a US bank. Payment Type: Check MoneyOrder PurchaseOrder
Make payable to: Performance Dynamics Company Mail to: Educational Services, P.O. Box 1238, Magalia, CA 95954-1238 PO/Check Number: Billing Address1: Billing Address2: Billing Address3:
PO/Check Number: Billing Address1: Billing Address2: Billing Address3:
Please sign inside this box:
All changes and cancellations must be submitted in writing. Cancellation requests must be received in writing at least 14 days before the start date of the class in order to qualify for a refund; minus a $50 processing fee. No refunds will be issued after that time. Refunds will be processed based on the original form of payment within 60 days after the close of the class. No-shows will be charged the full registration fee. Written notices of cancellation must be sent to: Performance Dynamics Company Educational Services P.O. Box 1238, Magalia California 95954, USA FON: +1-530-873-0575 FAX: +1-530-873-6697 EMAIL: classes at perfdynamics . com Substitutions are allowed. A letter on your companys letterhead is required from the original registrant stating the conditions of the substitution and the name of the replacement. You can skip the next section ....
Credit Card:
(Sorry but we are unable to accept Diner's Club or other credit cards)
Name on Card: Card Number: 3-Digit Code: Expiration Date: Billing Address1: Billing Address2: Billing Address3: Mailing ZIP Code:
Is this a CORPORATE Credit Card? No Yes
Please make a CLEAR photocopy of the credit card (FRONT and BACK) and include it with this form. Keep in mind that the image will darken when it's faxed, so you may need to adjust the copier contrast accordingly.
All changes and cancellations must be submitted in writing. Cancellation requests must be received in writing at least 14 days before the start date of the class in order to qualify for a refund; minus a $50 processing fee. No refunds will be issued after that time. Refunds will be processed based on the original form of payment within 60 days after the close of the class. No-shows will be charged the full registration fee. Written notices of cancellation must be sent to: Performance Dynamics Company Educational Services P.O. Box 1238, Magalia California 95954, USA FON: +1-530-873-0575 FAX: +1-530-873-6697 EMAIL: Substitutions are allowed. A letter on your companys letterhead is required from the original registrant stating the conditions of the substitution and the name of the replacement.