Training Registration

Please complete this form and fax it to 905 522 7284, or mail the form together with the registration fee to:

Clinical DataFax Systems Inc.
25 Main Street West, Suite 500
Hamilton, ON L8P 1H1

Registrant Information

Name
Company
Address
City, Prov/State
Country, Postal Code
Telephone
Fax
Email

Course Selection:

To indicate your course selection(s), circle the appropriate row(s) and transcribe the Course Fee to the Fee column.

Course Dates Course Fee Fee
DataFax Study Setup TBA $US 1000
Edit Checks TBA $US 1000
DataFax System Administration TBA $US 500
Sub-total $US
If applicable, subtract 50% academic/not-for-profit discount $US
Add 13% HST $US
Total $US

Additional Information:

All courses will be held at the offices of Clinical DataFax Systems in Hamilton, Ontario, Canada.

The course fee includes a course workbook and lunch(es).
Each course day runs from 8:30am - 5:00pm.
The dress is business casual.

To Register

Registration is on a first-come, first-served basis and is limited to 10 students per course. Up to 5 additional registrations will be kept on a waiting list.

To reserve a spot in one or more courses, print the registration form, and fax it to Clinical DataFax Systems at 905 522 7284. The registration will be confirmed when payment of the course fees is received.

Full payment must be received 30 days prior to the course or the reservation will be released to the waiting list.

Cancellation Policy

The following cancellation policy applies to all training courses:

Cancellations made up to 30 days prior to the course are 100% refunded.
Except in the case of a documented medical emergency, cancellations made between 14 and 30 days prior to the course are subject to a 50% penalty, and cancellations within 14 days of the course are subject to a 100% penalty.
Clinical DataFax Systems reserves the right to cancel a course should there be insufficient registration.