Audiometric Baseline Consulting Registration Form
If you have questions call (412) 831-0430

(Print and fill out the information and send with Check or Money Order to ABC). Indicate with an "X" which workshop you will be attending:


March 2017----------- 20 Hour Workshop -
March 30 & March 31 - 8:00am to 5:30pm
April 1 - 8:00am - noon
March 30 -> April 1,2017
$675.00
----------- 8 Hour Workshop -
March 31, 2017
$475.00
8:00am to 5:30pm

June 2017----------- 20 Hour Workshop -
June 8 -> 10, $675.00
June 8 & 9 - 8:00am to 5:30pm
June 10 - 8:00am - noon
----------- 8 Hour Workshop -
June 9, 2017
$475.00
8:00am to 5:30pm

Sept 2017----------- 20 Hour Workshop -
Sept 14 -> 16, 2017
$675.00
Sept 14 & 15 - 8:00am to 5:30pm
Sept 16- 8:00am - noon
----------- 8 Hour Workshop
Sept 15, 2017
$475.00
8:00am to 5:30pm

Nov 2017----------- 20 Hour Workshop$675.00
Nov 16 & 17 - 8:00am Nov 18 - 8:00am - noon
----------- 8 Hour Workshop
to 5:30pm
Nov 17, 2017
$475.00
8:00am to 5:30pm

 

Name: __________________________ Your Email: ________________________

Title: ____________________________

Home Address: _________________________________________________

Home Phone: __________________________________________________

Work Phone: __________________________________________________

Place of Employment: _____________________________________________
Make Check or money order payable to: Audiometric Baseline Consulting
2754 South Park Road,
Bethel Park, Pa. ,15102