Class Registratioin

Please complete and submit this form for any Public Class for which
you would like to register.  Use this registration form to sign up for multiple classes at one time.  You may register a single student for up to 3
classes on each form.  A CompuTrain representative will follow-up with a phone call to confirm your registration and to arrange for payment.  For additional information, please call  (713) 349-9186.

COURSE NAME MONTH

DAY

STUDENT INFORMATION

Name


Address

City

State

Zip

Phone

E-mail


Please check if Contact and Billing Information is the same.


BILLING INFORMATION

Company Name


Contact Name

Address

City

State

Zip

Phone

Email