[InterSystems employees please register here.]

Customer Registration

*Choose a course:

*Choose an in-person or virtual session:

*Attendee(s) to Register:

*First Name:

*Last Name:

*E-mail:

Contact information
*First Name:

*Last Name:
*Contact E-mail:
	Copy information from first attendee

*Organization:

*Address:

More Address:

City:

State:

Zip Code:

Country:

*Phone Number:

Fax:


	*I agree to the Release of Attendance Data Agreement.
	CONSENT FOR RELEASE OF ATTENDANCE DATA InterSystems can only disclose your attendance information for this training to your employer or InterSystems employees not involved in providing training with your explicit consent. InterSystems employees to whom we may disclose attendance includes, but is not limited to, support, implementation, and your sales team so that they can provide better support and success management. Individuals registering themselves: Do you consent to InterSystems sharing your attendance information with your employer and InterSystems staff not involved in providing training, for the purposes of your company and InterSystems employees supporting your company being aware that you've attended the training, and for identifying individuals or organizations in compliance with any contractual training requirements (if they exist)? Individuals registering others: You acknowledge and represent that the person or persons you are registering consent to InterSystems sharing their attendance information with their employer and InterSystems employees not involved in providing training, for the purposes of their company and InterSystems employees supporting their company being aware that they've attended the training, and for identifying individuals or organizations in compliance with any contractual training requirements (if they exist)?

	Yes
	No

Form of payment

Payments must be received in advance. InterSystems reserves the right to cancel or reschedule a class at least 10 business days prior to the announced start date. We will usually cancel a class if there are fewer than five registrants. In the event of cancellation by InterSystems, we will refund any payment made for the canceled course.

Tuition is fully refundable if a registrant notifies InterSystems at least 10 business days prior to the announced start date. For cancellation received afterward, we will provide a credit toward a future class.

Visa/Master Card/American Express

(You will be contacted via telephone for credit card information)

Purchase Order

(Purchase Order information will need to be provided prior to the start of class.)

Please submit your information only once

*Denotes a required field