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Contact Person's e-mail address*:
(e.g., john.doe@anycompany.com) |
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Contact Person's Company Name*: |
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Contact Person's mailing address*:
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John A. Doe
Street Address
City, State Zip Code) | |
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Contact Person's Phone#*:
(e.g., 248 xxx-xxxx) |
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Contact Person's Fax#:
(e.g., 248-xxx-xxxx) |
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Billing Address:
(Please provide if different than Contact Person's mailing address) |
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Customer Type*: |
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Method of Payment*: (Select one) |
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If:
Project Related:
Provide Project# and/or FANUC Robotics America Project Manager's Name in field below. |
If:
Purchase Order:
Fax PO to 248-377-7367 for a FANUC Robotics America invoice. NO INVOICE WILL BE SENT WITHOUT A PURCHASE ORDER. |
Credit Card:
Training registrar will contact for card# and expiration date within 2 days of receipt of registration. |
Wire transfer:
Training registrar will contact within 2 days of receipt of registration with details. |
Mailing check:
Send check a minimum of 2 weeks prior to training class and mail to:
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FANUC Robotics America
Drawer # 5739
P.O. Box 79001
Detroit, MI 48279-5739 | | |
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Project# and/or FANUC Robotics America Project Manager's Name:
(e.g., 12345F, Project Manager) |
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Company Name for student(s) being registered*:
(e.g., FANUC Robotics America) |
Company Name is same as above (Contact Company Name).
If not, please fill-in Company Name: |
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If you are an integrator, is the student an employee of your company? |
Yes
No |
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Student Full Name(s) or Total number of students attending*:
(e.g., Chris Smith) or (e.g., a number) |
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Class Name*: |
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Start Date of Class*:
(xx/xx/xxxx) |
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Alternate Date of Class:
(xx/xx/xxxx) |
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Time of Class*:
(as noted in schedule)
(e.g., 8:00 am - 3:30 pm) |
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Robot Model*:
(e.g., S430i) |
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Controller Type*:
(e.g., RJ3) |
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Version of Software:
(complete for programming classes only)
(e.g., Handling Tool 5.11) |
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Comments/Questions: |
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