REGISTRATION FORM

for

CPIM or CSCP Workshops

Please print out and mail along with payment.

APICS, Worcester County Chapter #22, Inc.

Making Business Run Better

Certification Workshops

Name_____________________________ Title______________________________

Address__________________________ Company__________________________

City_____________________________ Phone____________________(Home/Work)

State___________ Zip______________
e-mail______________________________

APICS Member?(Y/N)_______ Chapter______________
Member ID:_____________

Workshop title:____________________________________Fee___________

Location:_____________________________
Meeting Night___________

Fee Total:________________

Make Checks payable to APICS, Worcester County Chapter.

CPIM WorkShops

$450 APICS Members

$650 Non-members

CSCP Workshops

$2,095 APICS Members

$2,2295 Non-members

MAIL REGISTRATIONS TO:

APICS Worcester County Chapter PO Box 523 Worcester MA 01604