EMI Class Registration
  Fill in the following information and print out on your computer. Then fax this page to EMI Training at: 907-272-0319.
  Important:   You must submit a phone number that EMI can reach you at in case the class is canceled due to low enrollment.  If you wish to cancel your registration and do not notify EMI one business day in advance you will be billed $50 to the type of payment you have chosen.  To register using this form you must secure your class with a credit card or a company purchase order number. 
Class Registration Information
  Class Number 
  Class Name 
  Class Date 
 
Personal Information

Company Information
  Name  Company Name 
  Address  Address 
  City  City 
  State  State 
  Zip Code  Zip Code 
  Home Phone  Daytime Phone 
  E-mail  Fax 
 
Payment Method

Credit Card # 

Exp. Date 

    Company P.O. # 
 
If you don't have a fax,  Please phone us with the information that is listed above.  Just let us know how you will pay us and we will contact you for the specifics for our billing process.

Note: EMI Reserves the right to cancel any class when minimum enrollment is not met. 
 

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