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                           EDUCATIONAL REFUND FORM

 

DATE: ______________________

 

BUSINESS NAME: ________________________________________________

 

ADDRESS: ________________________________________________________

 

PHONE:  _______________________      FAX:  _________________________

 

 

 

CLAIM INFORMATION:

 

TYPE OF TRAINING:  ____________________________________________

 

DATE TAKEN:   _____________________  PLACE: _____________________

 

PERSON ATTENDING:  ____________________________________________

 

PLEASE ATTACH COPY OF REGISTRATION OR COPY OF REGISTRATION RECEIPT.

 

MAIL:    NGAEDA                                     FAX: NGAEDA

 

              620 4^TH. N.W.                                      (306)    773-3419

 

              SWIFT CURRENT, SK.

 

              S9H OV8

 

NGAEDA APPROVAL: ________________________________________________

 

DATE:   ______________________   CHEQUE # ___________________________

 

All rebates are subject to alteration or cancellation at any time.

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