Training Registration Form

* notes a required field
Student Name*
  
Does the student speak English?
  
Requestor Name*
  

Contact Information
Organization*
  
Street Address*
  
Address (cont.)
  
City*
  
State/Province*
  
Zip/Postal Code*
  
Country*
  
Work Phone*
  
Student email Address*
  
Requestor email Address
  

Hardware Support Location Information

Enrollees seeking a Software class mark this section with n/a.
Reason for enrollment.*
  
CS Project ID
  
Purchase Order Number *
If Paying by credit card, Call ibml and request for somone in the Training Dept. 		 
What service city will you be support?*
  
What account(s) will you be supporting?*
 
What account(s) are you already supporting?*
  
Are you the primary or secondary technician for these sites?*
  

Course Type
Courses
  
Requested Course Date
 mm/dd/yyyy  
On-Site Courses
 Select Additional Participants		  
Specialty Courses
  
Your ibml Contact Name*
(Who did you speak with about this class?) 		 
List Scanner Model(s)
  
Comments, additional information:
  

Additional Students
Student Name
 
Student email Address
 
Student Name
 
Student email Address
 
(Press 'submit' only ONCE ... to avoid duplicate entries.) By submitting this form you are agreeing to the ibml Training Terms. I have read and I do meet the minimum prerequisites for attending this class.
  
  Please allow time for form to process ... wait for the "Thank You" screen.