01/07/2012 - New Zealand Institute of Highway Technology - NZIHT
01/07/2012 - New Zealand Institute of Highway Technology - NZIHT
01/07/2012 - New Zealand Institute of Highway Technology - NZIHT
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Page 12July 2<strong>01</strong>1Short Course Registration FormName <strong>of</strong> <strong>NZIHT</strong> Short Course:__________________________________________________________________________Course Location:____________________________________Course Date:_ ______________________________________Name: ______________________________________________________________________________________________Name: ______________________________________________________________________________________________Name and Postal Address <strong>of</strong> your organisation: _ ______________________________________________________________________________________________________________________________________________________________Contact person: ____________________________________ Email: ____________________________________________All correspondence will be forwarded to the Contact PersonPhone: ____________________________________________Fax: ______________________________________________Order No: ___________________________________________________________________________________________Please note: Confirmation letters will be sent five working days prior to the course date.Cancellations: participant withdrawals must be notified in writing. Withdrawals after the close-<strong>of</strong>f date (5 working days prior to the coursedate) will be charged 50% <strong>of</strong> the course fee. Non attendance will also be charged the full rate. Substitute participants are welcome.Please refer to page 9 <strong>of</strong> our 2<strong>01</strong>1 Training Programme for full registration details and conditions.Course cost$ _ ____________________Plus 15% GST $ _ ____________________Cheque enclosed for: $ _ ____________________(Please make payable to the NZ <strong>Institute</strong> <strong>of</strong> <strong>Highway</strong> <strong>Technology</strong> Ltd), orThe <strong>NZIHT</strong> reserves the right to alter course dates, postponeor cancel courses due to unforeseen circumstances or wherenumbers are not sufficient.Post or Fax to:The Course Co-ordinator,<strong>New</strong> <strong>Zealand</strong> <strong>Institute</strong> <strong>of</strong> <strong>Highway</strong> <strong>Technology</strong> LtdPO Box 4273, <strong>New</strong> Plymouth 4340Phone (06) 759 7065, Fax (06) 759 7066Please invoice us for:$ _ ____________________FOR ALL ENQUIRIES: Phone: 06 759 7065, Fax: 06 759 7066FOR SHORT COURSES: Lisa Knowles : lisa@nziht.co.nz, Jan Kivell : jan@nziht.co.nzFOR DIPLOMA/DEGREE Jill Warner : jill@nziht.co.nzENQUIRIES:www.nziht.co.nzJAGO PRINT & GRAPHICS 82026
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