Porter Electric Training - Application Form

Porter Electric Training Class Application Form

To enroll, please print this Application Form, complete it, and return with a $125.00 minimum initial payment, a company purchase order, or fill in the credit card information below. You may also fax the application, or e-mail the application by clicking the button at the bottom of the page.

Mail Application and Payment to:

Porter Electric
P.O. Box 580843
Tulsa, Oklahoma 74158-0843

Tulsa Office: 888-293-2842 FAX: 918-835-2908

THERE WILL BE A $25.00 CHARGE FOR ANY RETURNED CHECKS!

Applicant:
Date:
Address:
City, State, ZIP:
Home Phone:
Business Phone:
Employer Company:

Check The Class-Starting Date You Prefer:

TULSA - January 28, 2008 April 21, 2008 July 14, 2008 October 13, 2008

MIDWEST CITY - January 30, 2008 April 23, 2008 July 16, 2008 October 15, 2008

PERSONAL TUTORING - Exact time and date will be pending verbal telephone confirmation.

Check One: VISA MASTERCARD DISCOVER

Name of Cardholder:
Address of Cardholder:
Credit Card No:
Exp. Date:
Charge: $525.00 (Unless prior arrangements are made.) Please indicate the alternate amount to be charged

Referred By: (Please Check One)

Newspaper Ad Co-Worker Mailer Other

Please Explain:

When complete, click here to send your application: