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Please select from the dates below:
April 19 - 21, 2006 (Registration deadline 3/31/06) June 14 - 16, 2006 (Registration deadline 5/31/06) I wish to participate ONLINE via WebEx/GoToMeeting 4/19 - 4/21 instead of the classroom session in Redmond I wish to participate ONLINE via WebEx/GoToMeeting 6/14 - 6/16 instead of the classroom session in Redmond
Please submit one form for all attendees from the same company.
Company Information:
Customer #: *
Company Name: *
Contact First Name: *
Contact Last Name: *
Address: *
City: *
State: *	Alabama Alaska Alberta Arizona Arkansas Armed Forces Americas Armed Forces Other Armed Forces Pacific British Columbia California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota North West Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming Yukon
Zip Code: *
Phone Number: *
Fax Number:
E-mail Address: *
Pricing:
All CMS Training sessions are $1295.00 for the entire three day classroom or online session.  This price includes continental breakfast, lunch and snacks each day for those attending the classroom session.  Complete training materials are also provided.  Customers currently enrolled in the 2006 CMS Support plan are entitled to receive a $100 discount off of this price. Please choose the appropriate amount:   Supported (includes $100 discounts): Non-supported: One attendee ($1195.00) One attendee ($1295.00) Two attendees ($2390.00) Two attendees ($2590.00) Three attendees ($3585.00) Three attendees ($3885.00)
Please enter the name(s) of your attendee(s):
PLEASE NOTE: Online training tuition is the same as classroom training tuition.
Payment:
Check if company address is the same as billing address.
First Name: *
Last Name: *
Billing Address: *
City: *
State: *	Alabama Alaska Alberta Arizona Arkansas Armed Forces Americas Armed Forces Other Armed Forces Pacific British Columbia California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Manitoba Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Brunswick New Hampshire New Jersey New Mexico New York Newfoundland and Labrador North Carolina North Dakota North West Territories Nova Scotia Nunavut Ohio Oklahoma Ontario Oregon Pennsylvania Prince Edward Island Puerto Rico Quebec Rhode Island Saskatchewan South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming Yukon
Zip Code: *
Name on Card: *
Card Type: *	Visa MasterCard American Express Discover
Card Number: *
CVC#: *
Card Expiration Date: *	01 02 03 04 05 06 07 08 09 10 11 12 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020
Cancellation policy: $100 cancellation fee up to 21 days prior to start of session. 50% of registration fee will be credited towards future session if cancelled 8 - 20 days prior to start of session. 25% of registration fee will be credited towards future session if cancelled 2 - 7 days prior to start of session. No refunds, no exceptions. NHS reserves the right to cancel training sessions at any time and refund all registration fees paid and assumes no responsibility or liability for delays, transportation, accommodations, injury, damage, loss, expense, illness or death.