Print this page to fax or mail

Click here to return to site

NTS TRAINING FORM 

FAX (814)-838-5127
ATTN: Dale Eller

MAIL FORM TO:

NYBFAA
Attn: Dale Eller
234 Hudson Ave. PMB#9401
Albany, NY  12210

First Name ________________________________________________
Last Name ________________________________________________
Email Address ____________________________________________
Employer (if applicable) ____________________________________
Mailing Address 1 _________________________________________
Address 2 ________________________________________________
Address 3 ________________________________________________
City _____________________________________________________
State ____________________________________________________
Zip ______________________________________________________
Daytime Phone ____________________________________________
Date of Birth ______________________________________________
List Desired Level   1, 2A, 2B  ____________________________
Fee per class is $325.00 for members and $425.00 for non-members
Checks must be received seven (7) days prior to class date
Level 1    March 5, 12, 19, 26, 2003         
Level 2A  April 9, 16, 23, 30, 2003
Level 2B  May 7, 14, 21, 28, 3003
classes are 3:00 pm - 8:00 pm

Click here to return to site