REGISTRATION
FORM
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. The email address is how Noria communicates important program details to you.
CANCELLATIONS AND SUBSTITUTIONS If you cannot attend the
course, a colleague can attend in your place. Registrations canceled
at any time prior to 10 days before the course are not subject to
fees. Cancellations after 10 days are subject to a $75 service charge.
Or, your registration fee can be transferred to another program of
your choice to be taken within 12 months. For more information, visit
Noria.com/train/registration.
CERTIFICATION EXAMS Certification testing is offered by the
International Council for Machinery Lubrication the morning following
a training course at the same hotel. Please contact ICML to register
for the certification exam or register online at LubeCouncil.org.
SATISFACTION GUARANTEE Noria proudly stands behind our
training courses. If you're not satisfied with the information and
insights you gain at these events, we'll refund 100% of your paid
registration fee.
PLEASE PRINT CLEARLY
HOW TO REGISTER
MAIL
(3-4 weeks processing)
Noria Training
1328 E. 43rd Court
Tulsa, OK 74105
ONLINE
Noria.com/training
FAX (3-4 days processing)
918-746-0925
PHONE
800-597-5460
or
918-749-1400
q Check is enclosed. (Allow 3-4 weeks for processing.) Please make checks
payable to Noria Corporation in U.S. dollars drawn on a U.S. bank.
q I authorize Noria Corporation to charge $__________________ to my:
q VISA q MasterCard q AMEX q Discover
Card Number Expiration Date
Signature
Print name as it appears on credit card bill
q Our purchase order is attached. P.O. Number
PLEASE REGISTER ME FOR THE FOLLOWING COURSE(S): COURSE DATE LOCATION
q Optional: Study Packet - Level I MLT / Level I MLA
q Machinery Lubrication II
q Oil Analysis II
q Optional: Study Packet – Level II MLA
q Oil Analysis III
Price includes shipping to a U.S. address
Price includes shipping to a U.S. address
$1,295
$295
$1,295
$1,295
$310
$1,295
q Machinery Lubrication I
Total Amount Due $___________________
Register online at Noria.com/training or call 800-597-5460
Note: Payment is due before the course.