DiiT Workshop Registration Form

You must be deaf or hard of hearing to register for a workshop.

All workshops are held at the Rochester Institute of Technology in Rochester, NY

 


Instructions

To register, print and complete the three parts of the Registration Form and send payment with all three parts to the address below:

Nina Lalka
RIT/NTID
53 Lomb Memorial Drive
Rosica Hall Suite 1120
Rochester, NY 14623

 


Questions

 For questions, please contact Nina Lalka at:

585-475-6239 (v)
email: nlalka@rit.edu


Workshop Cancelations

Conditions beyond our control may cause us to make changes in the workshops or cancel under-subscribed workshops.

Please verify your registration via email at nlalka@rit.edu before making non-refundable airline reservations.

If you must cancel your registration, and you notify us at least two weeks before the starting date of the workshop, you will receive a 100% refund. If you cancel after that date, you will receive an 80% refund.

Registration Form Part 1 – Workshop Registration

Register for two or more workshops and save 20% off your total registration.

Please register me for the following workshop(s):

Check

Workshop Title

Date

Cost

Check Your Skill Level

Begin

Inter

Adv

O

1. Microsoft Excel 2013: Beginning Level June 6 - 10 $500

X

O

O

O

2. Microsoft Excel 2013: Intermediate Level

June 13 - 17

$500

O

X

O

O 3. Grammar Review for Workplace
      Correspondence
May 23 - 27 $500

O

O O

 

Total Registration Fees                                                                       $_____________

Minus Discount                                                                                   $_____________

Total Cost                                                                                             $_____________


 


 Registration Form Part 2 – Registration Information

Name:

Home Street Address:

 City:

 State:

 Zip:

 Home Phone (V/TTY):

 E-mail (print clearly):

 Company Name:

 Company Street Address:

 City:

 State:

 Zip:

 Work Phone (V/TTY):

 Your Job Title:

Registration Form Part 3 – Payment Information

IMPORTANT NOTE:  A check, money order, or credit card information must accompany all registrations.

Please check form of payment:

š

Check payable to NTID.

š

Money Order payable to NTID.

š

Credit Card. (Fill in all information.)

š MasterCard             š Visa               š Other  ______________________________

Card #:  

Expiration Date:

Card holder’s name as it appears on the card (please print):

Card holder’s signature:

Total amount to charge to card:  $