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CPOŽ Course Registration Form

Certified Pool Operations Registration

CARI Centre, Charlottetown, PE
June 14 - 16, 2010

Please submit a registration form for each person attending the course. 

RFANS is pleased to accept payment by VISA or MasterCard.

HST #885076364


Name:

Address:

City/Town:

Province:

Postal Code:

Phone:

Fax:

Email:

Are you a member of RFANS, RNB or RPEI?
 Yes - Fee $449.95 + 13% HST
 No - Fee is $499.95 + 13% HST
 I don't know
Payment:
 Payment will be mailed directly to RFANS
 Please send an invoice to the address listed above
 Want to pay with VISA/MC
If paying by PO, please enter the number here:

Comments:
Any special considerations we should be aware of?