PolyReg: Registration form for training courses 2017

(Form to be printed; please mark your selected course)
Initial Training (Fr. 650.--)
IT17-01 Zurich / G, 30.05.2017
IT17-02 Geneva / F, 21.06.2017
IT17-03 Zurich / G, 06.07.2017
IT17-04 Lugano / I, 13.07.2017
IT17-05 Zurich / G, 31.08.2017
IT17-06 Zurich / G, 26.09.2017
IT17-07 Lugano / I, 03.10.2017
IT17-08 Zurich / G, 31.10.2017
IT17-09 Zurich / G, 14.11.2017
IT17-10 Lausanne / F, 22.11.2017
IT17-11 Lugano / I, 30.11.2017
IT17-12 Zurich / E, 14.12.2017
Recurrent Training (Fr. 340.--)
RT17-01 Zurich / G, 23.05.2017
RT17-02 Zurich / G, 13.06.2017
RT17-03 Geneva / F, 22.06.2017
RT17-04 Zurich / G, 27.06.2017
RT17-05 St. Gallen / G, 29.06.2017
RT17-06 Zurich / G, 11.07.2017
RT17-07 Lugano / I, 14.07.2017
RT17-08 Zurich / G, 22.08.2017
RT17-09 Olten / G, 06.09.2017
RT17-10 Bern / G, 07.09.2017
RT17-11 Zurich / G, 14.09.2017
RT17-12 Zurich / G, 19.09.2017
Recurrent Training (continued):
RT17-13 Lugano / I, 04.10.2017
RT17-14 Zurich / G, 05.10.2017
RT17-15 Zurich / G, 26.10.2017
RT17-23 Lugano / I, 03.11.2017
RT17-16 Zurich / G, 07.11.2017
RT17-17 Lausanne / F, 23.11.2017
RT17-18 Zurich / G, 28.11.2017
RT17-19 Lugano / I, 01.12.2017
RT17-20 Zurich / E, 05.12.2017
RT17-21 Zurich / E, 12.12.2017
RT17-22 Zurich / G, 21.12.2017
Reserve

Member:
(other Members you represent:)
Name / First name:
Title / Function:
Address: Zipcode/Place:
Phone: E-Mail:
Date: Signature:

If you assume functions for more than one member of PolyReg please indicate those firms. The first member mentioned will be invoiced.
Send to: PolyReg General Self-Regulatory Organisation, Training administration, Florastrasse 44, 8008 Zürich
or fax to: 043 / 499 80 56.
Registrations sent by e-mail can not be accepted.
This registration is binding. The following charges will be made for no-shows or cancellations:
- up to 4 days before the course: 30% of the costs.
- 3 days or less before the course: 60% of the costs.