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

Course Costs

DIPLOMA PROGRAM

Multimedia Format
 

$1407 - Plus 15 DVDs
$1877 - Plus 33 DVDs
$1977 - Plus 37 DVDs

Online Format

$794.00 - No DVDs
$1229 - Plus 15 DVDs
$1699 - Plus 33 DVDs
$1799 - Plus 37 DVDs

CD-Rom Format

$794 - No DVDs
$1214 - Plus 15 DVDs
$1684 - Plus 33 DVDs
$1784 - Plus 37 DVDs

CERTIFICATE PROGRAM

Online Format

$424.00

CD-Rom Format

$424.00

OPTIONAL

Enter Total Course Costs Here

$x

Enter Total Options Here

$x

Enter Sub Total Here

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*

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 – 1^st Avenue,

Queen Charlotte, BC V0T 1S0

Toll Free fax 1-888-559-8331