AGC Training Center - (Page 34) Enrollment Form Register online at www.agc-ca.org or complete the enrollment form and return with your check made payable to “AGC of California” or with your credit card information. Mail or fax the form to the numbers listed at right. A contact name, phone number, fax number, and attendees’ names are necessary; along with email addresses should AGC need to advise students of class changes or cancellations. You will receive a confirmation for the registered class. CANCELLATIONS: Cancellations must be made in writing, by fax or e-mail 72 hours prior to the start date of class for registrants to receive a refund. All persons that do not cancel their registration are responsible for full payment. 3 E-MAIL EASY WAYS TO REGISTER! online: www.agc-ca.org fax: 626-608-5810 mail: AGC OF CALIFORNIA 1906 West Garvey Avenue South Suite 100 West Covina, CA 91790 REGISTRANT INFORMATION — Use one form for each class, and list participants. NAME NAME E-MAIL NAME E-MAIL NAME E-MAIL NAME E-MAIL COMPANY INFORMATION COMPANY ADDRESS CITY STATE ZIP TELEPHONE FAX E-MAIL ❏ AGC OF CALIFORNIA MEMBER ❏ NON-MEMBER COURSE TITLE DATE COST # OF ATTENDEES TOTAL PAYMENT INFORMATION (Checks made payable to AGC OF CALIFORNIA, and mailed to address above) TYPE OF CARD: ❏ MASTERCARD ❏ VISA ❏ AMERICAN EXPRESS EXPIRATION DATE SECURITY CODE CARD NUMBER PRINT NAME OF CARDHOLDER SIGNATURE OF CARDHOLDER DATE AGC Education Foundation 34 ■■ AGC-CA ï TRAINING AND EDUCATIONAL CATALOG 2009 www.agc-ca.org http://www.agc-ca.org http://www.agc-ca.org http://www.agc-ca.org
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