Individual Course Registration Form

For Use With On-Line Credit Card Payments Only

This credit card transaction is secured by

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This registration form is for one person only, registering for one or more courses at a time.

Directions:

Step 1.  Identify course titles and course dates for each course you wish to take:

Note: for the Cabin Safety Symposium, enter "Symposium" and its location (e.g., Torrance, CA.).  For pre or post-symposium courses  enter the name of the course(s)

Note:  If you are registering for an international course,  enter the name of course and its location  (e.g., Czech Republic, Iceland, Canada)

Step 2.  Calculate the total tuition fees for all classes for which you are registering.

(Note:  if the registration fee is shown in euros, please convert the euros to dollars using the conversion rate in effect at the time of payment.  A currency converter can be found at http://www.xe.com/ucc/)

Step 3.  Complete Credit Card Input Below

List course(s) and dates selected; please include name of student and name of company or organization

Note:  When listing courses and dates, please use course designators such as  "AAI" for "Aircraft Accident Investigation." To register for the AAI course in July 2011 you would enter:   AAI  11-22 Jul 2011. If you are signing up for more than one course/event,  just enter them separated by commas such as:  SMS-C 10-14 Jan 2011, ISMS 17-21 Jan 2011 and so on. [Dates are illustrative only.]

Name on Credit Card

Total Purchase Price