highrely training registration form

1
Company Name Full Name Title Address City State Zip Code Country Phone E-mail Address Referred by (Company Name) Credit Card (Visa, MasterCard, Amex) Expiration Date Company Full Name Address City State Zip Code Phone E-mail Select the class date and location you would like to attend: Training Registration Form Attendee Information: Billing Information: Billing Address (if Different) 1747 E. Morten Avenue, Suite 202 HighRely, Inc. Email: [email protected] Phoenix, AZ 85020 Page 1 of 1 +1 602 443 RELY T USA Training Registration Form +1 480 452 0951 F Seminar Registration Fee Payment & Cancellation Policy - Registration Fee for US Training 2-Days Seminar is $1,695.00 USD - Registration Fee for Europe Training 2-Days Seminar is €1,000.00 EURO 10% Discount for registration confirmed 21 days in advance of class 20% Discount for additional registered attendees from the same company. Please fax or email completed form to: Fax to: 480-452-0951 Email to: [email protected] If you have any further questions, please feel free to contact us @ 602-443-7359 ** Cancellation made at least 14 days prior to the training date will receive a Full Refund ** In place of a refund, payments made can be applied to the next available class. Country Include Day 3 (free & optional, US only) + DO-178B to DO-178C Migration + Process Management for DO-178B/C projects + Modeling for safety certification + ARINC-653 and partitioned RTOS solutions + Testing strategies for certification Notes:

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Page 1: HighRely Training Registration Form

Company Name

Full Name Title

Address

City State Zip Code

Country Phone

E-mail Address

Referred by (Company Name)

Credit Card (Visa, MasterCard, Amex)

Expiration Date

Company

Full Name

Address

City

State

Zip Code

Phone

E-mail

Select the class date and location you would like to attend:

Training Registration Form

Attendee Information:

Billing Information:

Billing Address (if Different)

1747 E. Morten Avenue, Suite 202 HighRely, Inc. Email: [email protected]

Phoenix, AZ 85020 Page 1 of 1 +1 602 443 RELY T

USA Training Registration Form +1 480 452 0951 F

Seminar Registration Fee Payment & Cancellation Policy

- Registration Fee for US Training 2-Days Seminar is $1,695.00 USD - Registration Fee for Europe Training 2-Days Seminar is €1,000.00 EURO 10% Discount for registration confirmed 21 days in advance of class 20% Discount for additional registered attendees from the same company.

Please fax or email completed form to: Fax to: 480-452-0951

Email to: [email protected]

If you have any further questions, please feel free to contact us @ 602-443-7359

** Cancellation made at least 14 days prior to the training date will receive a Full Refund

** In place of a refund, payments made can be applied to the next available class.

Country

Include Day 3 (free & optional, US only)+ DO-178B to DO-178C Migration + Process Management for DO-178B/C projects + Modeling for safety certification + ARINC-653 and partitioned RTOS solutions + Testing strategies for certification

Notes: