Class Registration Form

for: TLB Level 2 Nov on Nov 08, 2010 to Nov 12, 2009


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: TLB Level 2 Nov 8800 Rostin Road Southaven MS 38671-1022 ATTN: Louise Harrison
Please insure that the COURSE NUMBER, DATES and Personal Information are correct.

Your Attendees

for: TLB Level 2 Nov on Nov 08, 2010 to Nov 12, 2009