Training

CBISA™ Training Registration Form

Please indicate which training you would like to attend

	Date and Location	Time
	June 22, 2009, Executrain (MicroTek*) -Las Vegas, NV	8:00 am to 3:00 pm
	July 9, 2009, MicroTek* -Chicago (Oak Brook), IL	9:00 am to 4:30 pm

Attendee and Billing Information

Name
Organization
Street Address
City
State/Province
Zip/Postal Code
Country
Work Phone
Fax
Email

Indicate Membership In:

CHA VHA

$595.00 $475.00 (VHA and CHA Members)

Invoice my facility OR Bill my charge card (complete info below)

Mastercard Number
Expiration Date
VISA Number
Expiration Date

Please note: Please register promptly to prevent class cancellation due to an insufficient number of registrants. We recommend making any flight reservations (if applicable) AFTER your training session has been confirmed by Lyon Software. Any training fees may be refunded up until the session has been confirmed; however, after confirmation, all fees are non-refundable, unless Lyon Software cancels a training class.

*Follow the link to MicroTek Labs to find out important information regarding your travel arrangements. Corporate rates apply at select hotels, along with shuttle service to and from the training site.