After ACT receives your completed registration form, a email confirmation will be sent to you within 5 working days. If you do not receive a written confirmation, contact Stephen Johnson by phone at 804-285-5830.

Person authorizing registration:
Authorizing Person's E-mail address:
Company:
Billing Address:
City State and Zip:
Contact's Phone Number:
Contact's Fax Number:
NOTE: This form may be used to register one or more students into a single class. If you wish to enroll in multiple classes, please reuse the form for each class, changing the appropriate fields.
Name(s) of Student(s), phone number(s) and email address(es) (in case of emergency):
	Class in which you wish to register the above student(s):
Class Title:
Class Begin Date:
Location:	Select location Richmond
	ACT accepts the following Credit Cards: If paying by credit card, please call us at 804-285-5830 at least a week in advance of the class to provide the credit card information for payment.
Payment Type:	Select Payment Type Company Check Individual Check Credit Card Bill to Authorizing Person
Please tell us to whom the invoice should be mailed and any special instructions required for billing, including billing contact information if different than authorizing person. Please indicate User Group affiliation for applicable discounts, as well as FREE Hotel Room needed and arrival and departure dates when appropriate. How did you find Advanced Concepts Training Corporation? ( e.g. Browser search (Yahoo, Google, MSN, etc), friend, work contact, phone book, previously took a course, instructor for another class, etc.) We like to know how we can better get the word out about our classes.

To register by fax to (804) 285-3722 - Download a PDF Registration form.

Note for RISE Members only: ACT public classes for which a student is requesting RISE member discount pricing should be done by submitting this registration, and indicating "RISE MEMBER" in the special instructions box.

Cancellation policy: In order to avoid being assessed the full quoted price for the class, ACT must receive written cancellations before the close of business two business weeks prior to the start of the class (no less than fifteen calendar days). ACT reserves the right to cancel class if it does not meet the minimum fill rate. Please contact ACT if you are registered for a class and extenuating circumstances will prevent you from attending.