Technical Training Registration Form 2016 Direct Fired Courses INTERNATIONAL, INC. Please select session: AMT – AERCO Master Technician: 5 days, Blauvelt NY, $1450.00 with hotel OR $950.00 without hotel ATT – AERCO Trained Technician: 4 days, Blauvelt NY, $1250.00 with hotel OR $850.00 without hotel ATT – AERCO Trained Technician: 2 days, any Regional Training Center, $850.00 with hotel OR $650.00 without hotel ProtoNode: 2 days, Blauvelt NY, $625.00 with hotel OR $425.00 without hotel Multi Fuel Condensing (MFC): 2 days, Blauvelt NY, $625.00 with hotel OR $425.00 without hotel DBS – Design, Build and Service Solutions: 2 days, Blauvelt NY, Free (attendees pay all travel and hotel costs) Site Personnel – Benchmark Thousand Series, 1-1/2 days, Blauvelt NY, Free (attendees pay all travel and hotel costs) Site Personnel – Innovation, 1-1/2 days, Blauvelt NY, Free (attendees pay all travel and hotel costs) Site Personnel – Modulex, 1-1/2 days, Blauvelt NY, Free (attendees pay all travel and hotel costs) Site Personnel – Benchmark 6000, 1 day, Blauvelt NY, Free (attendees pay all travel and hotel costs) Site Personnel – Legacy Benchmark + KC1000, 1-1/2 days, Blauvelt NY, Free (attendees pay all travel and hotel costs) Submit this completed form to your local AERCO sales representative for processing. You can find your rep using a zip code locator our website at: www.aerco.com Upon receipt of this form and payment, you will receive confirmation of your reservation. No reservations or confirmation will be made until payment is received. Name of Attendee Accommodations 1. Hotel No Hotel 2. Hotel No Hotel Authorizing Person or Supervisor Payment Information Payment must be by check or credit card only. Purchase orders will not be accepted. Class confirmation and hotel arrangements will not be made until payment has been received. Primary Contact Check or Money Order Enclosed (payable to AERCO Technical Training and include Acct #626.01) E-Mail ( Credit Card ) MasterCard Visa American Express Phone ( Class Start Date ) Fax Card Number Expiration Date: Company Name Street Address City Name on Card State Zip Signature AERCO Rep/Sponsor: Name Firm Date Sponsor, please email this completed form to Training@aerco.com or fax to (845) 580-8090 ATTN: Shannon /