On-Line Class Registration Request Form

General Information
Company Name: *
Company Address: *
Contact Person: *
Phone: *		(Country - Area/City - Prefix - Suffix) - - -
Fax:		(Country - Area/City - Prefix - Suffix) - - -
E-mail:
Please select one of the following, if applicable:
Representative Distributor VASH OEM

Class Information Refer to the Training Schedules for a list of classes, dates, and prices. Motion Control Training Schedule - 3rd Quarter 2008 Motion Control Training Schedule - 4th Quarter 2008
Class and Date: *
Student's Names:

Please fill out one form per class. Upon proper completion and submission, we will contact you with costs and availability of class. Please e-mail Rose Kolstad (rose.kolstad@danahermotion.com) with any questions or comments, or call (800) 558-4808, ext. 7794 or (920) 906-7794.