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NORIA TRAINING
REGISTRATION
Last Name First Name Middle Initial
Job Title Organization/Business Name
Mailing Address
City State/Province Postal Code/ZIP Country
Phone Fax
Email (required)
Note: The mailing address is where all mailed correspondence about this registration will be sent. Please print email address clearly. This is how Noria communicates
important program details to you.
❑ Check is enclosed. (Allow 3-4 weeks for processing.) Please make checks pay-
able to Noria Corporation in U.S. dollars drawn on a U.S. bank.
❑ I authorize Noria Corporation to charge $__________________ to my:
❑ VISA ❑ MasterCard ❑ AMEX ❑ Discover
Card Number Expiration Date
Signature
Print name as it appears on credit card bill
❑ Our purchase order is attached.
P.O. Number
If your plans change and you cannot attend the course, a colleague
can attend in your place. Registrations cancelled at any time prior to
10 days before the course are not subject to any fee. Cancellations
after that time are subject to a $75 service charge. Or, your registra-
tion fee can be transferred to another program of your choice to be
taken within 12 months. Visit www.noria.com/train/registration for
the complete cancellation and transfer policy.
PLEASE PRINT CLEARLY
CANCELLATIONS AND SUBSTITUTIONS
HOW TO REGISTER
MAIL
(Allow 3-4 weeks for processing)
Noria Training
1328 E. 43rd Court
Tulsa, OK 74105
ONLINE
www.noria.com
Register online to expe-
dite your registration.
FAX
(Allow 3-4 days for
processing.)
+1-918-746-0925
PHONE
800-597-5460
or
918-749-1400
Certifi cation testing is off ered by ICML the morning following a train-
ing course at the same hotel. Please contact ICML to register for the
certifi cation exam or register online at their website:
International Council for Machinery Lubrication
Phone: 918-259-2950 • Fax: 918-259-0177
Email: info@lubecouncil.org • Website: lubecouncil.org
CERTIFICATION EXAMS
PLEASE REGISTER ME FOR THE FOLLOWING COURSE(S): COURSE DATE LOCATION
❑ Optional: Study Packet - Level I MLT / Level I MLA
❑ Machinery Lubrication II
❑ Oil Analysis II
❑ Optional: Study Packet – Level II MLA
❑ Oil Analysis III
❑ Optional: Study Packet – Level III MLA
Price includes shipping to a U.S. address
Price includes shipping to a U.S. address
Price includes shipping to a U.S. address
$1,295
$355
$1,295
$1,295
$310
$1,295
$288
$1,295
❑ Machinery Lubrication I
❑ Industrial Lubrication Fundamentals
Total Amount Due $___________________
Payment is due before the course
