STIM-LAB, Inc. A Core Laboratories Company 7406 North Hwy 81 Duncan, Oklahoma 73533 Phone: 580-252-4309 Fax: 580-252-6979 www. Corelab.com PREDICT-K TRAINING, OPEN COURSE, HOUSTON, TEXAS Please complete and submit this form via email to: judy.conway@corelab.com. Your registration will not be complete until payment is received. If you are the fifth or greater registrant from your company, you will be advised that you are on a waiting list and your credit card will not be processed until space is available. You will receive a confirmation email when your registration is complete. Location: ProTechnics Division of Core Lab, 6510 W. Sam Houston Pkwy N., Houston, TX Date: November 11, 2014 Fees: $700 US I (check one) Registration cutoff: October 26, 2014 or when class is filled do do not desire to be added to a waiting list if necessary. Name of Attendee: Company: Participant’s Work Address: Email: Credit Card: Phone: VISA MasterCard Card Number: Expiration date and CVV Code: Card Billing Address w/zip code: Name on card if different from attendee: AmerEx