Mechanical Engineering
Manufacturing Engineering

Registration for Accelerated CNC @ WPI

Prices listed below are for a single person and the full amount must be pre-paid to reserve a seat. You can sign up by calling Toby Bergstrom at +1-508-831-5122 with course title, section, date, and credit card information or by printing out this page, filling in required fields, and faxing to Toby Bergstrom at +1-508-831-5673. Checks should be made out to "WPI".

Sign-Up

Name:__________________________________________

Address:_______________________________________

_______________________________________________

_______________________________________________

Phone:_________________________________________

Method of Payment

__ Check

__ Discover

__ Visa

__ MasterCard

__ American Express

Credit Card #:_________________________________

Expiration Date:_______________________________

Name on Card:__________________________________

(Please print name exactly as it appears on the card)

Signature:_____________________________________

Maintained by webmaster@wpi.edu
Last modified: October 09, 2006 14:17:26