|
FAX or Mail-in Registration
Form
DESIGN FOR END-OF-LIFE
MANAGEMENT
FOR ELECTRONIC PRODUCTS
| May 9, 2002 |
Classroom Training |
8 AM to 5 PM |
| May 10, 2002 |
Hands-on Training |
8 AM to noon |
Sponsored by Portland State
University and Zero Waste Alliance
Held at the Capital Center, 18640 NW Walker Rd., Beaverton, OR 97006
To register online, go
to: http://www.pware.com/index.cfm?clientid=1343&subeventdisp=202&event=BF209
| Last name
___________________ |
First ____________ |
MI ____ |
| Home
address ___________________________________________ |
| City
________________________ |
State ______ |
Zip _________ |
| Business/Organization
__________________________________________ |
| Business
Address _____________________________________________ |
| City
________________________ |
State ______ |
Zip _________ |
| Phone
______________________ |
Fax ____________ |
|
| Email
________________________________________________________ |
May 9 attendance
required for May 10 participation
I am registering for (check
all that apply):
___ $ 95.00 May 9 in-class training only.
Postmarked after April 22: $115.00
___ $190.00 May 9 and 10 in-class and hands-on training.
Postmarked after April 22: $210.00
Total $_____________
(Course # BF 209)
Payment method:
___ Check enclosed (make payable to PSU
Extended Studies, mailing address below)
___ Purchase order # ______________
Billing
address for P.O.
___ VISA
card __________________________________ Exp date
_______
___ MasterCard __________________________________ Exp date
_______
Authorized signature
______________________________________________ |
Mail to: PSU
Extended Studies Environmental Programs, PO Box 1491, Portland, OR
97207
Fax to: 503-725-4840
Registration questions: Call PSU Extended Studies
800-547-8887, ext 4618 or 503-725-4618 or email questions to
onlinereg@ses.pdx.edu.
For all other questions, please call Wayne Rifer, 503-644-0294.
|