System Integrator Course
Online Registration Form

Date: July 15th - 17th 2009 Place: Washtenaw Community College in classroom GL104 Please fill out the registration form below. Once submitted, you will have the payment options of either using a major credit card through an online secure server or check/money order through the mail. * = required. Registration Type * GLREA Member... $475 Non-member ... $500 Name * GLREA Member * Yes No Did you successfully complete the PV Apprentice Course?* Yes No - If you have not passed the PV course then instructor approval is required to take the course. Company/Organization E-Mail * Address * Address 2 City * State * Zip Code * Country * Day Phone * Evening Phone * Payment Method Will Be * (Mac users please select check or money order) Credit Card Check or Money Order :: Mac users :: Due to technical difficulty with the credit card processor, we are unable to process your payment online if you're using any browser on Mac OS. Please send a check or money order.