Please fill out the following information so you may be included in our emailing of course information.

Even though we depend on email for our coorespondence with participants, we will also need your mailing address to send the course work materials to you.

If your viewer is unable to handle forms, please print this form, and fax to 502-212-7504.

Name:
Company:
Address(line 1):
Address(line 2):
City:
State or Province:
Postal/ZIP Code:
Country:
Phone Number:
Fax Number:
E-Mail:(Required)
Primary business is: Embroiderer    Digitizer    Other,specify:
How long has your firm been in business: years
Please give us a brief description of your business:
NOTE any comments or specific requests below for prompt attention:

When the above information is completed, click on the following "SUBMIT FORM" button to automatically send it to us.

If you do not see a "SUBMIT FORM" button, that means your browser does not support forms. So print this form, fill it out and fax it to 502/212-7504.