The Ergonomics Center Of North Carolina - Ergonomics Training


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REGISTRATION

*required fields

Workshop you
wish to attend*

Course Date

Name (Mr./Ms./Dr.)*

Birthdate*

Title*

Company*

Postal Address*

City*

State*

Zip*

Country*

Phone Number*

Fax

Email Address*

To receive discounts on your training fees, become a member. If you are not interested in becoming a member skip the next section and proceed to the payment options.

Select Membership Level

Sustaining $250

Professional $500
(Choosing this level can save you $400 on the Industrial Process Workshop)

Site Level Consulting $3000

Site Level Training $3000
(Choosing this level can save you $2400 if you have three people registered for Industrial Process Workshop)

Corporate $5000

NC Government Partnership (No Cost)

Indicate name of person to receive membership materials:

Name Title

Payment Options

Payment Type*

If paying by check, please make check out to NC State University and mail to: The Ergonomics Center of North Carolina, 3701 Neil Street, Raleigh, NC 27607
If paying by credit card, a Center representative will contact you to obtain card information.
If joining as a member to receive membership discounts, please select the appropriate Membership Level above.

Company PO#

Continuing Education Units (CEUs) are awarded through NC State University and CM points are awarded through ABIH.

Registration and Cancellation Policy

I have read and understand the Center's Registration and Cancellation Policy.