Generic Enrollment Form for an ACDC Class

Download the Form Here

ACDC CLASS

40 Boyd Street, Worcester, MA  01606·Phone: 800.939.7909 · Fax: 508.856-9280
Email: craig@fixhybrid.com 

Class & Tech Information

Class Name*:
City*: Class Dates*: Date(s) * *Year 20

Shop Name*:

Street*: City*:

State*: Zip*:

Name of Student #1*: Cell #*: -

E-mail Address*:

Name of Student #2: Cell #: -

E-mail Address:

Name of Student #3: Cell #: -

E-mail Address:

Questions for Craig or specific areas you would like to have covered:

1.

2.

3.

Shop Contact (one responsible for payment)*:

Shop Phone (area code)*: - Fax number*: -

Paying by Check
Please make checks out to ACDC for total charges & fees.
Mail check:  40 Boyd Street,Worcester,MA 01606

Credit Card Payments

Name On Card: Total Charges to Card: $

Credit Card Number: Security Code:

Credit Card Type: Exp: /

I authorize my CC  for payment of the entire class. Sign here __________________________________________

Print name Today's date   __________/_________/_________

 

Sign up for the ACDC Newsletter on our web site

Refunds

Refund Policy: No refund 30 days before start of class.

Full refund minus $95 non-refundable enrollment fee if canceled in writing 30 days ahead or you can substitute another qualified person.

I understand the refund policy   ____________________________________________________

Use one form per tech/partner or spouse
Print & Fax form to 508 856-9280 (secure fax) or Email to   craig@fixhybrid.com