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REGISTRATION FORM - SPIROMETRY TRAINING
Name and
Title________________________________________________________
Company_______________________________________________________________
Street________________________________________________________________
CITY, STATE/ZIP_______________________________________________________
Phone_________________________________________________________________
FAX___________________________________________________________________
EMAIL_________________________________________________________________
Home
Phone____________________________________________________________
Course
Date_________________________Location ____________________________
Spirometer Type Used:_________________________________________________
Please call our office if you plan to bring your own
equipment.
Registration Fee: $495 Please send a check along
with this registration form
Due 2 weeks prior to course. No refunds but
transferable.
Mail To:Palmer Associates Inc.
1840 41st Ave Suite 102-258
Capitola, CA, 95010
Phone: (831) 239 0422
FAX:
(831) 462-5652
Make checks
payable to: Palmer Associates Inc.