Application Form - jklgrooming.com (complete this form online, print, then sign and mail)
Course Costs
DIPLOMA COURSE COSTS
Multimedia Format
$1002 w/No DVDs $1407 w/15 DVDs $1877 w/33 DVDs $1977 w/37 DVDs
Online Format
$794 w/No DVDs $1229 w/15 DVDs $1699 w/33 DVDs $1799 w/37 DVDs
CD-Rom Format
$794 w/No DVDs $1214 w/15 DVDs $1684 w/33 DVDs $1784 w/37 DVDs
CERTIFICATE COURSE COSTS
$424
OPTIONS
$75 (optional)
Total Course Costs
$x
Total Options
Sub Total Here
gst or hst (Canada Only)
Enter Total Amount
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
Cardholder Signature
x______________________
Print Exact Name on Card
Cash Payment International Money Order, Bank Draft Certified or Cashier’s Check
Make Payable to:
JKL Training Academy
Box 249, 604 – 1st Avenue
Queen Charlotte, BC V0T 1S0
Toll Free Fax 1-888-559-8331