Application Form - jklgrooming.com
(complete this form online, print, then sign and mail)

 

Credit/Debit Card

Cash (5% discount)

DIPLOMA PROGRAM

Multimedia Format
+ 9 DVDs

$1289.00

$1243.65

Online Format

$794.00

$756.05

CD-Rom Format

$794.00

$757.55

CERTIFICATE PROGRAM

Online Format

$424.00

$404.55

CD-Rom Format

$424.00

$406.05

OPTIONAL

Add: 9 DVDs (Diploma Online or Diploma CD-Rom ONLY) $297.00 (optional)
(9 DVDs = 297) Canada Residents add $14.85 gst
Paper Testing & Exam Option
Convert to Paper Testing & Exam (for those unable to complete lesson testing online, paper testing will be mailed to you.)
$25  (optional)


 

Enter Total Course Costs Here

$x

Enter Total Options Here

$x

Enter Sub Total Here

$x

Enter 5% g.s.t. (Canada Only)

$ 

Enter Total Amount Enclosed

$x

APPLICANT INFORMATION

Mr   Mrs   Ms

Name*

Mailing Address*

Street Address ( same) – or –

City*

Province/State*

Postal Code / Zip*

Country*    Canada             USA                  Other

Phone* / Fax (xxx-xxx-xxxx)

Email address*

Date of Birth* (mm/dd/yyyy)

Current Occupation*

Comments Today’s Date

PAYMENT INFORMATION

Credit/Debit Card
MasterCard
Visa

Credit Card Number:
/ / /  
Expiry Date (mm/yy)

/
3 digit security code

Signature of Cardholder
   

 

Print Exact Name on Card

Cash Payment
International Money Order, Bank Draft
Certified or Cashier’s Check
Wire Transfer (call or email for details)

Make Payable to:

JKL Training Academy, Box 249, 604 – 1st Avenue, Queen Charlotte, BC V0T 1S0
Toll Free fax 1-888-559-8331

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                             then Mail or Fax to JKL Training Academy