Medical Imaging Equipment Repair Technician Training Registration

Medical Imaging Equipment Repair Technician Training Registration
Register to participate in specialized training for medical imaging equipment repair technicians. Please complete all sections to ensure your spot.
Full Name
First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Current Employer or Institution
Job Title/Role
Mailing Address
Street Address
Street Address Line 2
CityState / ProvincePostal / Zip Code
Select Training Session
Please describe your prior experience with medical imaging equipment repair
Do you hold any relevant certifications or credentials?
Other certification(s)
Do you have any dietary restrictions or accessibility needs?
Emergency Contact Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Should be Empty: