Registration Form for Corlyx Corporation's
Consulting Class

To afford you flexibility, we will accept your registration by phone, fax, or U.S. Postal Service.
You may pay with Master Card, Visa, or, of course, your personal check.

All registrations must be made in advance of the class date, as we cannot accept registrations at the door.

To register by phone:  Call 303-693-7555 and use your Master Card or Visa.

To register by fax:  Fill in the registration information below, print this page, and fax to 303-699-2852 with your Master Card or Visa information included where indicated on the form.

To register by U.S. Mail:  Fill in the registration information below and print this page.  Enclose your check, or complete the credit card portion of the form, and mail to P. O. Box 441350, Aurora, CO 80044.

(* denotes required fields)

*Name:
Company Name:
*Address:
*City:   *State:   *Zip:
*Telephone:   *Email:
                                    (Your confirmation will be returned via Email)

Consulting Specialties #1:
                       #2:
                       #3:

*

Check Enclosed for $189.00 made payable to: Corlyx Corporation
     * -OR-
Charge Credit Card Number:   Exp.Date (mm/yy):

Signature:   *Date:
                  (Required if using Credit Card)

Share with the Alliance of Professional Consultants for inclusion on its email guest list for APC meeting announcements?

Privacy Policy:   Your registration information will be maintained in complete confidence by Corlyx Corporation and shared only with the Alliance of Professional Consultants if you so indicate on the registration form.   Your credit card information will never be shared with anyone!