TRAINING ONLINE REGISTRATION

Please complete the form below to register for a training course.

Note: Completing the registration page only registers the student for the desired course. No payment will be received until class becomes full. If class does meet the required minimum enrollment of 8-10 students, the class will be cancelled and the student will be contacted.

Step 1: Please Provide Your Contact Information

Registration Payment Instructions

After we receive the completed registration form, one of our training coordinators will call to confirm your place in the class. At that time, you can tell us how you will be paying for the class.

We accept Check, Purchase Order, or Credit Card.
PLEASE NOTE: Your registration will not be confirmed until full payment is received.

If you are paying by credit card, the following information is required.
Credit Card Type - (VISA, Master Card, AMEX)
Card Numbers
Name - as it appears on card
Security Code – 3-digit code found on the back of the card
Credit Card Authorization Form – We must have a completed form on file before your card will be charged.
Copies – of the front and back of the card and of the drivers license of the cardholder

If you are paying by wire transfer, please contact Maria Jacobs at maria@technicaldiagnostic.com.

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15825 Trinity Blvd Fort Worth, Texas 76155       Phone: 817.465.9494       Toll-Free: 1.800.225.7271       Fax: 817.465.9573       info@technicaldiagnostic.com
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