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  Validation Certification - Registration Form  
 
Fecha:
Name:
Company:
Address:
Telephone:
Celular:
Work Telephone:
Email:
Fax:
 
Seminar:
  *Professional Module Require General Module Completion.
Cost:
   
Payment  
Check - Make check payable to: Universida Politécnica de P.R.
Credit Card - We accecpt VISA,Master Card, and American Express. Call to give us your credit card information. 
787.622.8000 Exts. 470, 429
 





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Copyrights © 2005
Polytechnic University of Puerto Rico Center for Education & Training
Tel: 787.765.5974   Fax: 787.274.8562
787.622.8000 Exts. 470, 429   787.758.7915
www.pupr.edu/continuinged
cgodoy@pupr.edu
lwattley@pupr.edu