CUSTOM FIT

ed2go Registration

Company requests that Mountainland Technical College (Custom Fit) enroll the employee(s) listed below, in an online course. Company agrees to pay the discounted Custom Fit Price for the individual(s) listed below. Company will be charged once the employee has registered for the course online, using the PassCode.

"*" indicates required fields

Company Information

Company Name or Organization*

Company Address*

Street Address Address Line 2 City State ZIP Code

Contact Name*

Contact Email*

Contact Phone*

Course Information

Course Name*

Start Date*

Per person or total cost?

Per person

Total cost

Published Price*

to be paid by Custom Fit

Custom Fit Price*

to be paid by the Company

Purpose of Training*

Are you paying by Credit Card?

Yes

Employee Information

An email address is required for online courses.

Employee Information*

Full Name

Email

Phone

Authorized Company Signature

Disclaimer: Trainee information will be used for internal purposes only and will not be sold.

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