ASQ Course Registration Form

Course	Start	Duration	Member Fee Nonmember
Certified Manager of Quality/ Organizational Excellence Refresher	18:00 27 Nov 2007	10 weeks 3 hours per week	$1,150	$1,300
Certified Six Sigma Black Belt Refresher	18:00 29 Nov 2007	10 weeks 3 hours per week	$1,150	$1,300
Certified Quality Inspector Refresher	18:00 2 Jan 2008	7 weeks 3 hours per week	$860	$1,000
Certified Quality Engineer Refresher	18:00 4 Mar 2008	10 weeks 3 hours per week	$1,150	$1,300
Certified Six Sigma Green Belt Refresher	18:00 19 Mar 2008	7 weeks 3 hours per week	$860	$1,000
Certified Quality Auditor Refresher	18:00 20 Mar 2008	7 weeks 3 hours per week	$860	$1,000

ASQ Course Registration Form

Course: CQE CSSBB CSSGB CMQ/OE CQA CQIA CQI CQT CRE Fee: __________

Name: _________________________________ e-mail: __________________________________

Company: ______________________________ Phone: __________________________________

Address: _______________________________ Home Address: ____________________________

City: _____________ Province/State: _____ _______ Home City: ___________ Home Province/State: ___________

Country: __________ Postal Code/ZIP: ___________ Home Country: ________ Home Postal Code/ZIP: __________

Send form to: Make cheque to: ASQ Montreal Section 401

Education Chair

ASQ Montreal Section 401

159 chemin Stillview

Pointe-Claire Québec H9R 2Y1