Registration Form
IGSHPA Installer Course
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Registration for : 1009-27  - IGSHPA Accredited Installer Course  - September 27-29, 2010  - Milwaukee, WI 
 
Name
Company
           
    Address                          
   
City State     Zip/Postal code      
       
Phone(include area code) Fax(include area code)  
   
E-mail No. of Students
               
    Additional participant’s name            
               
    Additional participant’s name            
               
    Additional participant’s name            
               
    Additional participant’s name            
  Payment Information: Choose One  
Pay By Check Paypal
   
 
Send Check With Completed Form To
Earth Energy Services LLC
W6744 Rogersville Road
Fond du Lac, WI 54937


Questions? Please contact
Rich at 1-920-246-5159 or
Joel at 1-920-979-5452
Rich.Susens@gmail.com
Code Name Date Location
Fees $
1009-27  IGSHPA Accredited Installer Course  September 27-29, 2010  Milwaukee, WI 
Cancellation Policy
Accredited Installer and Accredited Driller Workshops - The full tuition will be refunded if you cancel your registration at least two (2) weeks prior to the first day of the confirmed workshop. The full fee will be charged if you do not attend and do not cancel the registration at least fourteen (14) days before the workshop. You may designate another individual as your substitute at any time.
   
Copyrighted 2007 Earth Energy Services LLC