DMIA's 2002 School for Forms Specialists

schools  
 

May 4-7 • Chicago
September 7-10 • Boston

Online Registration

Please note: Required fields are in red.


Student's Name   
     Male Female
Nickname for Badge   
Certification Status    CFC/CDC CPSS
Company Name   
Are you DMIA member?    Yes No
Membership Number   
Designation    Distributor
Manufacturer
Supplier
Street Address   
City, State, Zip   
Phone Number   
Fax Number   
Email Address   
Home Phone Number   
Student's Job Title   
Months in Printing/Forms Industry   
Explain Nature of Position   
Approving Manager Name   

Company Principal or Supervisor:
Complete the following two fields if final grade and other follow-up materials are to be sent to supervisor.
Company Principal/Supervisor Name   
Company Principal/Supervisor Title   
 
Tuition
(includes all online modules):		    DMIA Member Rate: $965
Non-Member Rate: $1,660
The school tuition does not include room and board.
 
I am registering for
(please check the appropriate box):		    May 4-7 – Chicago
Sept. 7-10 – Boston
Your prerequisite reading and preparatory material and conference center information will be shipped upon receipt of registration and tuition.
 
Payment Method   
Card Number   
Expiration Date   
Cardholder's Name   

Notice: DMIA and its designated agents are authorized to charge this credit card for the full amount due. (Funds over the amount that you indicated as the total will be charged to you only in the event you under calculate your total.)

For Additional information, contact Harriet Carter, CDC or Lloyd Tucker at 800-336-4641. Call for information on Group Discounts.