This is a sign-up form for the Zeagle Regulator Service Seminar on November 4, 2011 to be given at the DEMA trade show in the Orange County Convention Center in Orlando. These Seminars are not open to the general public. All attendees must be affiliated with an authorized Zeagle Dealer.
1st Attendee's Name
*
2nd Attendee's Name
3rd Attendee's Name
4th Attendee's Name
Zeagle Account Number
*
I understand that $20 PER STORE ATTENDEE will be charged to the Dealer Account Number
*
Please Select
YES
NO (I won't be attending)
Enter the name of the person from the dive store who authorized a "YES" answer to the question above.
*
Store Name
*
Store Street Address
*
Store City
*
Store State or Province
*
Store ZIP or Postal Code
*
Store Country
*
Store E-mail Address
*
NOTE: A Confirmation E-mail and future correspondence will be sent to the Zeagle Dealer E-mail address given above. PLEASE DOUBLE AND TRIPLE CHECK THAT THIS ADDRESS IS CORRECT OR YOU MIGHT NOT GET A CONFIRMATION.
Store Phone # Including Area Code
*
Primary position of the 1st Attendee
*
Please Select
Store Owner
Manager
Service Technician
Sales Staff
Instructor
Other Store Position
Time since last Zeagle Service Seminar
*
Please Select
1 Year
2 Years
3 Years
4 Years
5+ Years
This is my First Zeagle Service Seminar
Preferred Session
*
Please Select
9:30 am - 12: pm
12:30 - 3:00 pm
3:30 pm - 6:00 pm
Additional Comments
Pre-entries must be submitted by October 25, 2011. After that, please come to the Zeagle Booth # 836 on the show floor to request remaining slots.
Submit Form to Zeagle
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