Course Registration
11110 Alondra Blvd.
Course Name: 2007 Smog Update Course
Course Dates:
July (Friday's) 23 & 30, 2010
August (Friday's) 20 & 27, 2010
September (Sunday's) 19 & 26, 2010
Phone: 562-860-2451
Attendee Information
Name:
Name (2):
Name (3):
Name (4):
Company:
Address:
State:
Zip/Postal Code:
Main Contact:
Email:
Phone:
Special Needs:
Registration Fees
Conference Fee: $ 300
x Number of Attendees:
Subtotal:
Total Due:
Payment
Credit Card
Check payable to:
Jannet Malig -
Automotive Technology
Cerritos College
11110 Alondra Blvd.
Norwalk, CA 90650
Mastercard
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Expiration Date:
Cardholder Name:
After payment is received confirmation
will be sent through email
Norwalk, CA 90650
Jannet Malig - Ext. 2912
www.cerritos.edu/auto
Cerritos College
Security Code:
Payment due by: 7/16/10, 8/13/10, 9/12/10
Course Location: Cerritos College
City:
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