GREAT SEMINARS AND BOOKS
REGISTRATION
Please print, fill out the registration form, and fax or mail to:
GREAT Institute
2639 Revere Drive
Akron, OH 44333-2311
Phone: 330-836-2275
Fax: 330-865-6941
Toll-Free: 877-79-GREAT
Email: GREATseminars@aol.com
Make all checks payable to: GREAT Seminars and Books, Inc.
Call GREAT Seminars and Books toll free at 877-79-GREAT with any questions.
NAME:
PROFESSION: PT PTA OT COTA (Please circle one)
HOME ADDRESS:
CITY:
STATE: ZIP:
HOME PHONE:
EMPLOYER/OFFICE:
BUSINESS PHONE:
COURSE YOU WILL BE ATTENDING:
LOCATION OF COURSE:
DATES OF COURSE:
CREDIT CARD NUMBER: EXP DATE (MO/YR):
NAME (as it appears on credit card):
CHECK NUMBER:
Cancellation Policy: Cancellations must be received in writing at least two weeks prior to the seminar date for a tuition refund less a $75 administration fee. No refunds will be made after this date.
Note: Registrations made within 2 weeks of the date of the seminar will incur a $75 late fee.