Product Training Courses Provided by CSC

42 Oliver Terrace,
Shelton, CT 06484
(203) 261-6074

To register for a class, please fill out the form below or print the registration form and fax it to (203) 459-1874.

Required information is highlighted in red.

Training Registration Form
Training Title:
Training Date:
Attendee Name(s):	Practice:
1)	Practitioner:
2)	Phone:
3)	Fax:
4)

Sessions (Check Attendees for Each Session)	Registration Fee Per Attendee
PPO or AS/PC® Training Seminars
Attendees: (1) $250 (2) $250 (3) $250 (4) $250		$250.00*
"Saturday Session" Seminars
Attendees: (1) $75 (2) $50 (3) $50 (4) $50		$75/50**
Web Seminars (Free On-Site)
Seminar Contact at Your Office for Set Up		$25**
Please Note: Early Registration Discounts - Subtract $50 per Attendee Day* 2nd Employee Discounts for Saturday Sessions subtract $25**

Check here if you have a CSC Limited or Comprehensive Support Contract.

Please state your objective in attending the class: