FDDI Institute Your Independent Education Partner [FDDI Institute logo]

Registration Form

Fax: 32 15 25 10 50

Registration made by:

(* are required fields)

* Name:
* Phone n°
Fax n°:
* Email address:
Function:
Department:
* Company/Organization:
* Invoice address:
* Postal Code:
* City:
Country:
V.A.T.:
Your order reference:

Participant:

* First Name:
* Name:
   Phone n°:                   Fax n°:
   Email addres:
   Department:
   Address:

* Start Date * Course Name Price

Prices include lunch & coffee breaks.
Classes are held form 9h to 17h. Location of Courses : Leuven
An invoice will be sent which has to be paid at least ten days before the beginning of the seminar on account number 789.5672053.93 or by sending us a cheque. Registration is not valid if this condition is not fulfilled.

Place, Date,

or print this form and fax it to: 32 15 25 10 50.
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FDDI Institute
De Regenboog 11 - 2800 Mechelen - Europe
Tel 32 15 24 50 58 - Fax 32 15 25 10 50
E-mail training@fddi.be