Prefix
*First Name
MI
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*Agency Name
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Address Line 2
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*Province	Choose a province Alberta British Colombia Manitoba New Brunswick Newfoundland Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan
*Postal Code
*Phone (including area code)
Fax (including area code)
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* Course Date / Location - Select the Course	Select a course 2008-12-02 / Richmond, BC Canada 2009-01-26 / Winnipeg, Manitoba
*Cost For FX ® Scenario Instructor / Safety Course	$450
*Cost for FX ® Re-Certification Course	$275
Date of last certification
Where did you hear about our training courses?
Today's Date :	November 20th, 2008

Administrative Policy:

1. Payment for the course is required in full within 30 days after course completion date. $50.00 per participant will be added to course tuition if payment is made after 30-day period.

2. Preferred forms of payment: Department / Agency Purchase Order, Company Check, Credit Card (MC, Visa), Certified Check or Money Order.

3. Cancellation Policy: Registrations cancelled seven (7) days prior to course convening date will be accepted. A processing fee of $100.00 will be assessed for course cancellations. Cancellation requests received after the seven-day advance period will not be accepted.

You will receive confirmation of course enrollment within two weeks of receipt.