E-REGISTRATION FORM

(Sensory Integration Certificate Program)

 

 

 

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First Name

Last Name

Profession

Level of Education

High School   BSc   MSc/PhD

Specialty

Current Work Location

Mobile #

E-Mail

Comments

Note: For Groups, use the "Comments" box to enter other names/persons of the group.

Fee Structure:

1. $ 1,700 per Individual.

2. $ 1,500/head for a Group of Five (5) Persons or More.

3. $ 1,500 if you register within Two (2) Weeks of Course

    Announcement, or Before the 5th of January 2012.

Payment Method

1. Pay by Cheque

Make payable cheque under the name of: DroobTech Trading and

Services Est.

2. Pay By Cash

Call this number to make payment by Cash: +966 3 896 0994

3. Pay by Bank Transfer

Deposit the money in to the below mentioned Bank Account.

Bank Name

Country

City                            

Branch                     

Swift Code

Account Holder

Account Number

IBAN Number   

:

:

:

:

:

:

:

:

Samba Financial Group

Saudi Arabia 

Al-Khobar

Doha-NAF Commercial Center 

SAMBSARI 

DroobTech Trading Services EST.

0306903954

SA3740000000000306903954

 

 

 

 

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