1. Attendee Information

Your Name

This name will be printed on your certificate. Please type full name accurately.

Job Title

Company

Industry

Street Address

Street Address (cont.)

City

State/Province

Postal Code

Country

Work Phone

E-mail

Vegetarian or other dietary or barrier free needs if any.

2. Select Payment Method

The fee for this course is US$1,695 per attendee.

• The fee includes your course material, Modern QFD templates, lunch, and coffee breaks on December 15–16.

• A US$100 per person discount may be applied for registrations of 3 or more people from the same company submitted at the same time or registrations of US federal government employees with a valid ID.

Your total fee:  US$

Credit Card (Visa, MasterCard, AMEX)

Card Number

Expiration Date

Cardholder's Name

Cardholder's Email Address if different from the attendee

Credit Card Billing Address including Postal Code

I agree to the credit card charge by the QFD Institute of the amount typed above.

Check  (Checks must be in US$ drawn on a US bank, and arrive by December 1, 2008 unless other arrangements have been made with the QFDI in advance.)

Wire Transfer  (Wire transfer instructions will be e-mailed to you upon receipt of your registration. The transferred funds must arrive by December 1, 2008. Bank fees associated with wire transfer services are responsibility of the attendee; please instruct your purchasing department and bank to add applicable bank fees to your registration fees. Some countries may be beyond the service area of our bank. If so, we will contact you in 24 hours.))

TERMS & CONDITIONS

Late Registrations & Cut-off Date:  Registrations received after 12:00 pm noon December 10, 2008 may be subject to a 20% late registration surcharge due to the extra costs in material preparation. Registrations may close subject to seat availability or at 12:00 pm noon December 12, 2008, whichever comes first. All deadlines are by U.S. Eastern Time.

Cancellations After Registration & Substitutions:  Full refund or credit will be given when cancellation is notified by a pre-paid attendee by 5 pm November 10, 2008 (US Eastern Time).  No refund will be made after that. However, substitutions are permitted without penalty.

Course Cancellations by the QFD Institute: QFD Institute will make every effort to keep the published course schedule. Should the QFD Institute cancel a course, we will contact registered attendees immediately and refund the full course fees or credit the amount toward a future event. The QFD Institute's liability is specifically limited to refunding the applicable course fees and excludes any incidental or consequential damages.

Start and End Time: This course will be held from 8:00 AM – 4:00 PM on both December 15th and 16th. Please plan on full days on both days and plan your travel accordingly. Early departure could jeopardize your receiving the certificate.