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  1. Business Information

Salutation (e.g. Ms, Dr.) / First Name: / Middle Initial / Last Name: / Gender
Position / Nickname:
Company Name: / Department:
Company Address 1: / Company Address 2: / Company Address 3:
Company Telephone Number: / Company Fax Number: / Mobile Phone:
Mail to : Home Company / Bill to : Home Company
 / Your E-mail Address at Company:
  1. Company Information

Organization Type: / Key Decision Makers at this Location:
Tuition Paid 100% 50% 25% Other
by Company:  / Number of Employees
at this Location:
  1. Supervisor Information

Salutation (e.g. Ms., Dr.) / First Name: / Middle Initial / Last Name: / Gender
Position: / Dale Carnegie Training Graduate?
Yes No Do not know
Telephone Number: / Fax Number: / E-mail Address:
  1. Home Information

Home Address 1: / Home Address 2: / Home Address 3:
Home Telephone: / Home Fax: / Home E-mail:

ENROLLMENT AGREEMENT FOR DALE CARNEGIE TRAINING®

Tuition for The Dale Carnegie Course® is EC$5000 cash per person. Tuition is inclusive of books and supplies that are provided at no additional cost to participants. To register please complete this application and return to us along with your tuition in full. By registering, you indicate your intention to attend all sessions of the Course in which you are enrolled and to make up any session(s) from which you are absent provided space is available in subsequent classes. Make up privileges expire one year after the date of enrollment. Should you move from this area, you may complete your training within one year in any of the cities where the Course is presented at no additional cost.

NOTICE OF CANCELLATION

You may cancel this transaction, without penalty or obligation, by notifying this office prior to the start of session One. Any tuition paid will be refunded in full. If you are not completely satisfied at the close of the first session you attend and/or you do not attend any other session, tuition will be refunded in full provided that all books and supplies are returned in good condition. If books and supplies are not returned in good condition, then you will be refunded monies paid minus an EC$800). There will be no refund after a student attends subsequent sessions. Failure to complete the programme does not alter your tuition obligation in any way.

Qualifications of Trainers

Dale Carnegie® trainers are graduates of Dale Carnegie Training® who have backgrounds in executive or managerial positions, professions, sales management or engineering positions. After careful screening they receive intensive training to instruct the Course and are required to attend yearly refresher programs where they are examined as to their eligibility to instruct. This rigid screening and supervision is designed to ensure that they will be able to help you get the most out of the Course.

Enrollee Date

Enrollment accepted byDate

For Dale Carnegie Training® Use Only

Date / Amount / Balance / Form of Payment / Card/Cheque Number
Date / Amount / Balance / Form of Payment / Card/Cheque Number
Date / Amount / Balance / Form of Payment / Card/Cheque Number
Organizational Needs:
Class Number:

Note: All fees are payable in equivalent Eastern Caribbean dollars