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Open Enrollment I Contract Programs I One-To-One Programs I About EDC I Contact Us I Registrations I

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Print this Registration Form for Foundations of Leadership and fax to 309.677.4421

Date   
Salutation Mr.               Ms.             Mrs.                      
Full Name   
Nickname   
Title   
Organization   
Mailing Address   
City   
State   
Zip   
Phone (Office) (            )
Phone (Home) (            )          
Fax   
e-mail   
Program Title   
Date of Program   
Program Location   

Please charge the program fee to my credit card.
Card Type Visa ___ MasterCard___  Bill me___
Account #   
Expiration Month_________________ Year______________

Details on location and costs of accommodations will be sent prior to the program. Please call the program site to arrange your lodging.
      CANCELLATION POLICY
Before a program begins, the Executive Development Center incurs substantial administrative costs related to your registration. Therefore, registrations cancelled or transferred will incur the following charges:

> 25% of tuition if less than 4 weeks
> 75% of tuition if within 5 days of the program
> 100% of tuition on the starting day of the program

________________________________________________
Signature

 

 

 

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