Student Information
City, State and Zip:___________________________________________________
Email:______________________________________________________________
Phone Number:
_______________________
Fax:_______________________
Course Information
Course:
MCDBA Boot Camp (14 days)
Price:$6995
Course Date:
___________________________________________
Course Location:
Dallas
Payment Information
Check, Company PO or major credit
card are acceptable forms of payment. Make checks
payable to:
The-Web Communications, Inc. 637 Bay Green Dr.,
Suite 100, Arnold, MD. 21012
Circle Credit Card Type:
AmEx MasterCard Visa
Discover
I,_______________________, authorize The-Web
Communications, Inc. by phone to process credit card payment in lieu of manual
imprint and signature for goods and services rendering, and agree to
the training terms and
conditions.
Credit Card Number:
_____________________________________________________
Cardholder's Name:
______________________________________________________
Exp. Date:_________________ Amount:________________________
Authorized
Signature:_____________________________________________