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Application Form - jklgrooming.com
(complete this form online, print, then sign and
mail) |
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Credit/Debit Card |
Cash
(5% discount) |
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DIPLOMA PROGRAM |
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Multimedia Format
+ 9 DVDs
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$1289.00
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$1243.65
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Online Format |
$794.00
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$756.05
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CD-Rom Format |
$794.00
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$757.55
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CERTIFICATE PROGRAM |
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Online Format |
$424.00 |
$404.55 |
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CD-Rom Format |
$424.00
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$406.05
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OPTIONAL |
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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) |
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Enter Total Course Costs
Here |
$x |
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Enter Total Options Here |
$x |
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Enter Sub Total Here |
$x |
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Enter
5%
g.s.t.
(Canada Only) |
$
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Enter Total
Amount Enclosed |
$x |
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APPLICANT INFORMATION |
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Mr
Mrs
Ms |
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Name*
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Mailing Address*
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Street Address (√
same) – or – |
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City*
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Province/State*
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Postal Code / Zip*
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Country*
Canada
USA
Other |
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Phone* / Fax (xxx-xxx-xxxx)
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Email address*
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Date of Birth* (mm/dd/yyyy)
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Current Occupation*
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Comments
Today’s Date
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PAYMENT INFORMATION |
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Credit/Debit Card
MasterCard
Visa |
Credit Card Number:
/
/
/
Expiry Date (mm/yy)
/
3
digit security code
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Signature of Cardholder
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Print Exact Name on Card
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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 |