RAD-Ware Registration

Product Selection:

Qty

Course or Software

Select your training date

Month:

Year:

Are you a Nevada resident? (Applies to software only!)

No	Yes - Nevada adds 7.50% tax

Address:

Title

First Name

Last Name

Address 1

Address 2

City

State

Zip

Phone

Email Address

If you are paying by credit card, select the PayPal button on the screen page of your software or training course. If you have chosen another payment option, please indicate below:

If online payment is not an option for you, please fill in your credit card information in the boxes below:

Credit Card

Card Number

Expiration

Card Verification No.

Tell Me Who to Thank

Could I have some info about you?

Are you part of a group qualifying for a discount? Or would you just prefer to register with printed copy. I'm really interested in who you are and what your expectations are for the training you've chosen. So, if you could fill out the form, print and fax this registration, noting if you are part of a group or facility - and how many are attending. When complete, fax this form to RAD-Ware at 702-395-2824.