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Monterey County Fire Training Officers Association
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City of Monterey Training Registration Form

Rescue Systems 1

Attendee Information (Please Print or Type):
 

First Name

  

Last Name

  

Agency
 

 

Street Address

  

 

City

  

 

State

  

 

Zip
Phone # ( ) Fax # ( )  

E-Mail Address
EMT# Paramedic#

Course Information:

□ Rescue Systems 1, September 29 – October 3, 2008 - $495.00

(Refunds only issued for cancellations received by September 22, 2008)

Payment Options (Please enclose Payment with Registration Form):
Total Payment:  

  

$495.00

□ Visa, MasterCard or American Express Number:

 		 

 

Expiration Date:
 

Signature of Authorized Card Holder:
 

□ Purchase Order #:

 		 

 

Agency Contact Name:

□ Check:

Questions: Registration – 831-646-3900, Course Info – 831-646-3909

Return to: Monterey Fire Administration

610 Pacific Street

Monterey, CA 93940

Or Fax: 831-646-3723

Office Use Only

Date Received:___________________

Visa/MC/AE Authorization #______________________________

PO #_______________________ OR Check #_____________________

Entered By:______________________Date:_________________________