Tire Industry Association - TIA TRUCK TIRE TRAINING TOUR

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TIA "TRUCK TIRE TRAINING TOUR"
REGISTRATION FORM

I. OTHER WAYS TO REGISTER
Mail Tire Industry Association 1532 Pointer Ridge Place, Suite G Bowie, MD 20716-1883.	Fax 301.430.7283	Phone 800.876.8372 301.430.7280
Download this form as a PDF file. (click above to download. Then print it, fill it out and send or fax to TIA)

II. CONTACT INFORMATION

Company Contact:

Company Name:

Company Address:

City:

State:

Zip:

Country:

If applicable, please enter International Postal Code into the Zip field above.

Phone:

Fax:

E-mail:

III. TRAINING DATES & CITIES

Listed below are the dates and cities for TIAfs back-to-back, one-day Commercial Tire Service Technician Training and Certification seminars scheduled for Fall 2007. The first day's program is repeated on the second date listed for each location.

OCT. 2 & 3, 2007
Greensboro, N. Carolina
Holiday Inn
Greensboro Airport

OCT. 16 & 17, 2007
Orlando, Florida
Hampton Inn
International Airport

NOV. 13 & 14, 2007
Columbus, Ohio
Holiday Inn Hotel & Suites

NOV. 27 & 28, 2007
Hartford, Connecticut
Hampton Inn
Hartford Airport

DECEMBER 4 & 5, 2007
Chicago, Illinois
Hampton Inn - O'hare

DECEMBER 6 & 7, 2007
Kansas City, Missouri
Airport - Hampton Inn

IV. TOUR DATE SELECTION

Training Day 1 (fill in date here)
Please register		technician(s) for training and TIA CTS Manual(s)*	@ $300 each (incl. lunch)	=
Please register		technician(s) for training who already have TIA CTS Manual(s)*	@ $200 each (incl. lunch)	=

Training Day 2 (fill in date here)
		technician(s) for training and TIA CTS Manual(s)*	@ $300 each (incl. lunch)	=
		technician(s) for training who already have TIA CTS Manual(s)*	@ $200 each (incl. lunch)	=

	*CTS Manual required for exam.
TOTAL AMOUNT DUE				=

IV. METHOD OF PAYMENT

Payment :

PO Number:

Card Type:

Expiration:

Card Number:

Name On Card:

Amount: