EPSON Training Class Registration

To register for any of our training classes, please fill out the form below and click submit. You can also register for a training class by calling us at (562) 290-5910 or by downloading and printing the FAX registration PDF form and then faxing back to us at (562) 290-5999.

Registration Form

Student Information:

Mr. Mrs. Ms.
First Name:	Last Name:
Title:
Company:
Address1:
Address2:
City:	State:	Zip Code:
Country:
Phone:	Fax:
E-Mail:
Customer Type End User: OEM: Distributor: System Integrator:

Course Information:
Please select the course title and dates you wish to attend from either the Programming course list or the Maintenance course lists below.

	Developer Programming Courses: Other Course Title & Date (if not listed above):	Robot Maintenance & Technician Programming Courses:
	Robot Model : Robot Serial Num:	Controller Type: Controller Serial Num:

Method of Payment:
If you are applying a Robot / Vision Training Credit to reduce your tuition, please be sure to select Yes in the appropriate box below and fill in the serial number if it differs from the above Robot Serial Num: entry. To pay by credit card or check, please leave the Purchase Order Number: field blank, our sales representative will personally assist you through the credit card and or check payment process.

Using Robot Training Credit
Serial Number of Robot Used for Training Credit:
Purchase Order Number:

Important Notes:
Please don't enter your credit card number on this form. Approved payment method must be submitted before final seat confirmation. A $500 no show fee may be applied to delinquent participants if class registration waiting list exists. We kindly request cancellations submitted 3 weeks prior to your registered course start date. < Please don't make your travel arrangements until you receive final seat confirmation >

EPSON Training Class Registration

Registration Form

The Power of Choice!