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ONLINE PRE-REGISTRATION

Instructions: Please complete all the fields before submitting this application online. All information is strictly confidential.

This form is only for a preliminary reservation. Your registration will be confirmed when we receive your registration fee.
Applications will be acknowledged promptly by email. If you have not received an email acknowledgement it is likely that your application was not received.

Please contact us by fax: +1 413 517 0900 or email: Ms Theresa Leary

Please provide the following contact information

Name 
Institution
Address
Phone
Fax
E-mail

Please choose the school you want to attend.

Please choose the courses you want to make a reservation for. You can choose more than one course.

I will pay by

For your payments, please download the registration/payment form and fax/mail it to us. Your registration will be confirmed when we receive your registration fee.

Please write below any information or comments you would like us to know.


 

Contact us at office@ecomod.net

Last modified: May 09, 2007

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