You have chosen to register for:

Certificate in Business Administration Registration:
September 11 - November 20, 2008

REGISTRANT INFORMATION (press TAB to advance in the form)
Once we receive your registration, you will receive a confirmation packet via mail.

*Registrant Full Name: Mr. Mrs. Ms Miss

*Preferred Name:

Department/Organization:

Position:

Address:

City: State: Zip Code (+4): -

Day/Cell Phone:

E-Mail Address:

PAYMENT INFORMATION

Check
Credit Card (phone 800-284-6407 or fax (859) 257-4822 to provide credit card information)

Make check payable to:

International Business & Management Center (IBMC)
University of Kentucky
227 Gatton College of Business & Economics
Lexington, KY 40506-0034

**You will receive your confirmation packet via email

Do you wish to receive CE credits: YES NO
(If "YES", you will be asked for social security number at registration.)

How did you hear about this program: Website Mailing Newspaper/Magazine Referral
Other

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