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Global Educators Academy

Registration

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Tell us about yourself.
First Name:
 Last Name:
Telephone:
 Fax:
E-mail:
  
Company Name:
  
Address:
 
City/Town:
    
State/Province:
 Zip/Postal Code:
Country:
  

Select the seminar date you wish to attend.

Seminar date: 


Check all that apply.

  I am registering early.
  If applicable, enter Offer Code: 
  I will be attending with other team members.
Note: If this applies, please complete the following two questions. If it doesn't, skip down to the Registration & Payment section.

For Team Registration

If you wish to register other team members via this form, please provide their full name, phone and email address.

Tuition Calculation.

  1. Enter the total number of people being registered and paid for via this form:

  2. table

  3. Your tuition cost, per person, is: $
  4. Total tuition due is: $

Registration & Payment.

To register & pay online...

We accept MasterCard, VISA and American Express.

To register & pay by mail...

1. Make check payable to Partnerwerks Inc.
2. Print this form and mail it with check/P.O. to:

Partnerwerks
P.O. Box 1046,
Comfort, TX 78013

To register & pay by phone...

Call us at +1 830-995-4853, having the information on this form available along with either a credit card or Purchase Order number.

To register & pay by fax...

Print this form, then complete the following section and fax this form to 830-995-4854. If paying by credit card, we accept MasterCard, VISA and American Express.


Credit card #

  

Expiration date

  

Name on card

  

Signature

  

- or -


P. O. Number

  

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