SVG Test

Registration Form

All fields marked with an asterisk (*) are required.

Your Information
*First name
*Last name
*Email
*Phone
FAX
*Company
*Country
Address
City
State
Zip
Supervisor Information
*First name
*Last name
*Email
*Phone
Attendant Information
Attendants
Attendant 1
Reuse above information
*First name
*Last name
*Email
Attendant 2
*First name
*Last name
*Email
Attendant 3
*First name
*Last name
*Email
Attendant 4
*First name
*Last name
*Email
Attendant 5
*First name
*Last name
*Email
Attendant 6
*First name
*Last name
*Email
Attendant 7
*First name
*Last name
*Email
Attendant 8
*First name
*Last name
*Email
MLC Training Class
Class
Details
Duration:      PartNo:
Total Course Price: $    
($ Per Attendant)
Date
Do you own a Micromeritics Instrument?
Yes No
Instrument:
Serial Number
Payment Information
Payment Type
Please email P.O. Document to kara.bailey@micromeritics.com
If Course is part of an Instrument Purchase, please enter your Micromeritics Sales Representative or Distributor Name.
Sales Rep
Instructions
Comments
Comments




Registration Instructions

To Register your personnel, please complete this form and click the "Submit Registration" button. Clicking "Submit Registration" means you have read and understood our Registration, Attendance, and Cancellation Policy.

A Customer Service Representative will contact you within 48 hours to collect payment.

Course Space will not be reserved until an email confirmation is received from Customer Service.

Registrations are not confirmed until payment has been submitted.

If you need to speak with Customer Service sooner, please call (770) 662-3636 or send email to orders@Micromeritics.com.

Please note that slots are filled on a first come, first served, basis and cannot be guaranteed until Registration is confirmed.

Course dates are subject to change within 30 days or greater of the posted start date. If any scheduling problems arise, you will be contacted by the Micromeritics Learning Center manager in order to resolve the conflict.

Please feel free to contact the Micromeritics Learning Center coordinator,

Kara Bailey
(770) 662-3607
kara.bailey@micromeritics.com