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:
Purchase Order Money Order Check CashOther
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
Advertisements
HPS Newsletter Ad
HPS Newsletter Short Course Listing
RSO Magazine
NRRPT Newsletter
Nukeworker.com
Referred By:
Internet Search
All the Web
MSN
Yahoo
Google
AltaVista
Hot Bot
or Other:
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.


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