Registration

Complete this form by checking the seminars you wish to register for, and selecting the date you wish to attend. Additionally we have included a Print Ready Registration Form if your would like to submit your registration by mail/fax.

(denotes required information)

Seminars:

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		Starting Date:
	Lean Kaizen Boot Camp (5 Days) $2495.00	October 01, 2012
	Leading Lean (3 Days) $1695.00	May 16, 2012 December 10, 2012
	Lean Experience (5 Days) $2495.00	February 06, 2012 March 26, 2012 May 21, 2012 July 23, 2012 September 24, 2012 December 03, 2012
	Lean Value Stream Improvement (2 days) $1195.00	November 29, 2012

Attendee Information:

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Please select the number of attendees.

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Attendee #1
Name:			Position:
Phone:			Email:

Attendee #2
Name:			Position:
Phone:			Email:

Attendee #3
Name:			Position:
Phone:			Email:

Attendee #4
Name:			Position:
Phone:			Email:

Attendee #5
Name:			Position:
Phone:			Email:

Attendee #6
Name:			Position:
Phone:			Email:

Attendee #7
Name:			Position:
Phone:			Email:

Attendee #8
Name:			Position:
Phone:			Email:

Attendee #9
Name:			Position:
Phone:			Email:

Attendee #10
Name:			Position:
Phone:			Email:

Attendee #11
Name:			Position:
Phone:			Email:

Attendee #12
Name:			Position:
Phone:			Email:

Attendee #13
Name:			Position:
Phone:			Email:

Attendee #14
Name:			Position:
Phone:			Email:

Attendee #15
Name:			Position:
Phone:			Email:

Billing/Contact Information:

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First Name:			Email:
Last Name:
Company:			Phone:
Position:			Fax:
Address:			City:
(line 2):
State/Prov:		Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia US Virgin Islands Washington West Virginia Wisconsin Wyoming Alberta British Columbia Manitoba New Brunswick Newfoundland Northern Territory Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory	(other):
Zip Code:			Country:

How did you hear about us?

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Article Assembly Magazine Brochure Google Search Other Web search Friend/Colleague Newsletter Online Ad Other

Customer Code: (found above your name on the brochure)

Payment Method

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Seminar fees must be paid in advance (fees include breaks, lunch, some dinners, and session materials).

	Check Sent — Payable to Lean Learning Center
	Credit Card — Number: Exp:
	Bill Me — Please provide PO number (right)

Comments / Questions:

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Hotel and Travel

All sessions are held at the Lean Learning Center in Novi, Michigan.

Hotel and travel expenses are the participant's responsibility and are not included in the registration fees. Hotel information and directions will be included in your confirmation letter. Please be sure to identify yourself as a Lean Learning Center participant to receive the special rates. Check your confirmation letter for details.

Cancellation Policy

Registration fees will be refunded in full if cancellation is received up to five business days before the program commences. Cancellations after that time are eligible for a 50 percent refund up to the start date. No fees will be refunded after the session begins. Substitute participants are permitted; please notify us in advance by calling 561·626·0676.

Guaranteed Satisfaction

We're convinced that you'll benefit from attending our sessions. If you are ever dissatisfied with any session you attend through the Lean Learning Center, just let us know. You'll automatically receive a FREE scholarship to attend any equivalent seminar offered by the Center.