Class Registration Form
for: MH350D Nov 2010 on Nov 15, 2010 to Nov 19, 2010
5
Company Name:*
Your Name:*
Address:*
City/State/Zip/Country:*
Phone:*
Fax:
Email:*
Authorized By:
Terex reserves the right to cancel classes up to 21 days prior to the class start date if less than 3 people register. Please Note: Terex does not assume any liability for arranged travel or hotel accommodations made in advance of 21 days prior to class date. Distributor cancelations are due 21 days prior to class start date. Any cancelations after 21 days may be charged the full fee for the class. If you have any questions, please contact our training department at (662) 393-1349.
PO Number:
Number Attending:* $ 400.00 ea List Attendees


Terex Parts Distribution
For Class: MH350D Nov 2010
8800 Rostin Road
Southaven MS 38671-1022
ATTN: Louise Harrison


Please insure that the COURSE NUMBER, DATES and Personal Information are correct.