To purchase any of our training programs, please print this Fax Form from your browser. Fill out the form completely and fax to CBT Corp at 337-825-0019. To contact us by phone, call 1-888-CBT-TRAIN.
The prices quoted are for credit card purchases only. We accept all Major Credit Cards.

Company Name: _______________________________________________________

Your Name: ___________________________________________________________

Company Address: _____________________________________________________

Address 2: ____________________________________________________________

City:_____________________________________ 

State:_____________     Zip:_________________

Phone:____________________________ Fax:_______________________________

Your E-mail Address: ___________________________________________________

Qty ____ ESD Certification Program Version 5.0,  Full Single User Version $495.00 ea.

Qty ____ ESD Certification Program Version 5.0,  Upgrade Single User Version $379.00 ea.

(Must have version 2.01 or  4.0 or 4.1 loaded on your computer to be eligible for the upgrade.)

Qty ____ Hand Soldering  Program Version 2.0,  Upgrade version $379.00 ea.
(Must have version 1.1  loaded on your computer to be eligible for the upgrade.)

Qty ____ Hand Soldering Program Single User Version 3.0, $495.00 ea.

Qty ____ Hand Soldering Program Network Version 2.0, $995.00 ea.

Qty ____ Hand Tools Program Single User Version 1.1, $495.00 ea.

Qty ____ ESD Certification Program Version 5.0,  Network Version $995.00 ea.

Qty ____ ESD Certification Program Version 5.0,  Web-Based Version $5995.00 ea.
All programs come with Administrator 2007 for Free.

Add $4.50 for shipping for each program, in the United States.  Outside USA requires credit card number or FedEx account number.

Total:  _________________

Credit Card Number: ___________________________________________________

Credit Card Type (Visa List 3 Digit Code):_________________________ 

Date of Expiration:________________________

Signature: _________________________________________

FedEx Account Number: _________________________________________
 
Fax this form to CBT Corp at 337-825-0019