Student Information

Student Name*
Student Email*
Cell Phone*
Agency*
Address*
Training Manager's Name
Training Manager's Email
Training Manager's Phone

Course Information

Course Title*
Location and Date

Cancellation Policy: All cancellations and refund requests must be made in writing. All cancellations are subject to a $15 administrative fee. There will be no refunds or cancellations received 15 days or less prior to the start date of the course. Refunds will not be given for no-shows. *
Substitution Policy: Graves & Associates encourages you to make a substitution if a student cannot make it to the course; substitutions will be accepted prior to the course and on‐site. Substitutions must be made in writing when prior to the course and noted correctly on the roster on-site. *
Registration Policy: Graves & Associates will not register anyone for a class unless payment has been received in full. If you are not able to provide payment up front you may provide a credit card to hold the seat. However, all students must be paid in full by 10 days prior to the class, if payment is not received at that point and a card has been given to hold the seat, it will be charged. *

Payment Information

Course Cost*
Number of Attendees*
Total Cost*
Credit Card Authorization
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Card Holder Name*
Credit Card Number*
Expiration Date*
Security Code (CVV)*
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