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Enrollment Application

for Neely Coble
Company Training

Name:
Company Name:
Address 1:
Address 2:
City:
State:
Zip Code:
E-Mail:
Phone #:
Fax #:
Course Name:
Course Date:
Purchase Order #:
Approving Supervisor’s Name:
Approving Supervisor’s Phone #:
Comments:
 
Fee: $175.00 per day for each student. Purchase order # for the amount of the entire class must be received with the enrollment application unless prior arrangements have been made. Check payment for the entire class must be sent/brought to Neely Coble Company prior to or on the scheduled class date. A $150.00 cancellation fee will be charged for student cancellations from classes within 5 business days prior to the first day of class and for no-shows.

Note: This is only an application for admittance to the class requested above. As attendance is limited for each class, this application will be reviewed for space availability as well as the applicant’s compliance with being employed by an approved Freightliner dealer or customer.

Acceptance of this application will be sent to applicant organization via e-mail.

   
 
 
 

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