Advanced Anaerobic Bacteriology Course & Chamber Training Registration Form

2.5-day Anaerobic Bacteriology Seminar Includes:
Seminar, textbook, lab supplies, transportation to & from airport, 3 nights' hotel accommodations, breakfast, lunch, dinner Wednesday & Thursday. The cost per participant is free with the purchase of an Anaerobe Systems chamber or $2,995 for those who haven't purchased our chamber. Additional attendess for previous chamber purchases receive a 50% discount off of the public rate.

SEMINAR SPACE IS LIMITED, REGISTER EARLY!

Courses Conducted At:

Anaerobe Systems

15906 Concord Circle

Morgan Hill, CA 95037

Ph: (408) 782-7557

www.anaerobesystems.com

Enrollment Process:

Fill out and submit completed registration form.
Select your payment method, Anaerobe Systems will follow up for payment if it is required.
Await confirmation letter to confirm enrollment. Confirmations will be sent no later than 21 days prior to the seminar. If enrollment quota is not met, chamber training may be rescheduled.
Once you have received confirmation, make your travel arrangements. Please note that airfare is not included. Plan to arrive Tuesday afternoon/evening &depart after 1:00 p.m. Friday the week of the course.
Anaerobe Systems will provide transportation to and from the airport and to and from the hotel to Anaerobe Systems. If you will be staying in the local area on your own after the course, we can provide transportation to your next destination.
The event coordinator will make hotel arrangements in Morgan Hill, CA for Tuesday - Thursday nights.
For questions, call us or email the training coordinater at sandyburg@anaerobesytems.com .

Course Dates: *

Upcoming course dates can be found on our website.

Courses are conducted 4-5 times per year, Wed-Fri.

First Name *

Last Name *

Hospital/Company/Institution *

Address *

City *

State

Zip Code

Country

Cell Phone Number *

Email Address *

One complimentary registration with chamber purchase, include purchase order # or invoice #. Unlimited number of discounted registrations for prior chamber customers, include chamber model and serial #.

Registration / Payment Options (choose 1): *

Complimentary (include chamber purchase info)

$1,497.50 Discounted (include chamber serial number)

$2,995.00 Paid (credit card or purchase order)

Chamber Purchase PO or Invoice #

Chamber Serial #:

Credit Card Type

Name on Card

Credit Card Number

Expiration Date (mm/yy)

Anaerobe Systems will follow up for payment details. Payment can be made via credit card, or with a purchase order for customers with a current account.

Special Dietary Requirements?

Vegetarian

Allergy

Other Other

Hotel Accommodations *

2 Queen Beds

1 King Bed

If you have any questions please contact Sandy Burg at 1.800.443.3108 or sandyburg@anaerobesystems.com