Effective Contamination Control Enrollment Form

Please print this order form on your printer -- after completing
please mail or fax it to Noria Corporation, Attn: Seminars,
1328 E. 43rd Court, Tulsa, OK 74105 USA
FAX: 1-918-746-0925 PHONE: 1-918-749-1400

Please enroll me in the following course:   Effective Contamination Control - $995 Seminar City__________________________    Date__________________

Names of Attendees (Please Print) 1. Mr./Ms._____________________________ Title__________________________________ 2. Mr./Ms.____________________________ Title__________________________________ 3. Mr./Ms.____________________________ Title__________________________________ 4. Mr./Ms.____________________________ Title__________________________________

Company Information (Please Print) Organization:_____________________________ Address:________________________________ _______________________________________ City:____________________________________ State/Prov:______________  Zip/PC:___________ Country__________________________________ Phone:____________________________ Fax:______________________________ E-mail:____________________________

Method of Payment Check payable to Noria Corporation is enclosed. Charge to my credit card.     Card Type:_______________  Card # ___________________________     Expire Date: ___/___ Signature _________________________________ Purchase order is attached. PO Number____________________ I will pay at the seminar.

FAX: 1-918-746-0925 PHONE: 1-918-749-1400