Exon-Intron Workshop Registration Form

Please fill out this form, print it, and then FAX the completed form to 717-771-4062. If you wish to pay by credit card, Visa and Mastercard may be used to register for the Penn State workshops.  For added security, we will be happy to call you and take your billing information over the phone.  If you wish to pay by check, please fill out the form, print it, and mail it to the “Workshop Coordinator” at the address shown below. Registration forms must be accompanied by full tuition (US funds only) made payable to “Exon-Intron, Inc.”

Questions? Contact us via email (workshop@DNAtech.com) or call us directly at 717-428-0270.

Name:

Email:

Title:

Company or
Organization:

Address:

 

City:

State/Province:

Zip/Postal code:

Country:

Tel:

Please include telephone area code and country code if needed.

Fax:

CHECK BOX TO CHOOSE CLASS OR CLASSES

Course

Date

Location

Price
US$ per person

Check

PCR Methodology

May 16-20, 2011

Penn State York,     York, PA

$1550.00

Advanced PCR Techniques

May 23-27, 2011

Penn State York, York, PA 

$1550.00

Quantitative RNA Techniques

Call for dates

Penn State York, York, PA 

$1550.00

Credit Card Information. See above for other payment options.

Name as it appears on credit card:

Credit card number:

Expiration date as it appears on credit card:

Any special instructions? If you are registering more than one person, please tell us how many total people you are registering and enter their name or names here.

Notification of Training Cancellation Policies:
Tuition is refundable up to 30 days prior to the first day of the workshop; please note that cancellations are subject to a $100 administrative fee. A receipt and confirmation of registration will be issued when this form and tuition are received. Exon-Intron reserves the right to cancel any workshop, without penalty, up to 30 days prior to the first day of the workshop. In the unlikely event of such a cancellation, a full refund of any tuition received will be returned to each participant.

Exon-Intron, Inc.
WORKSHOP COORDINATOR
P.O. Box 395
Loganville, PA 17342
Tel: 717-428-0270
Fax: 717-771-4062
workshop@DNAtech.com

 

 

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