Pacific Power Products

*** TRAINING APPLICATION ***
*** ONE STUDENT PER APPLICATION ***
*** ONE CLASS PER APPLICATION ***

Supervisor:
Company Name:
Billing Address:
City
State/Zip:
Phone Number:	--
Fax Number:	--
Email Address:
Student's Name:
Last 4 Digits Student Social Security #:
Name of Class:
Location of Class:
Cost of Class:
P.O. Number:
Date Preference 1:
Date Preference 2:
Date Preference 3:


THIS IS AN ENROLLMENT FORM ONLY. THIS FORM DOES NOT GUARANTEE YOU A PLACE IN THE CLASS. Confirmation will be made before the start of each class. WE REQUIRE PAYMENT IN FULL TO ASSURE YOUR SPACE IN EACH CLASS. Please make payment for the class no later than 10 days prior to the class date. Cancellations made less than five calendar days prior to the class are subject to 50% of the class fee. If you have any questions please contact Connie Brown at (360) 887-7400 or Sherrill Fischer at (253) 854-0505.